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PubMed1989

Anthropometric assessment of nutritional status and growth of children in Democratic Yemen.

A cross-sectional study of 600 school children aged 7-13 years of both sexes was carried out in Aden city, Democratic yemen. Body weight, body height, mid-arm circumference and triceps skinfold thickness of left side were measured for each child. The results showed that the weights, heights, mid-arm circumference and triceps skinfold thickness are almost linear with increasing age among the studied group. Generally, girls showed significantly higher values of all studied anthropometric measurements than boys above 11 years. Following the approach of waterlow classification, the percentages of wasting, underweight, stunting and concurrent wasting and stunting were found to be 8.9%, 25.8%, 22.2% and 2.9% respectively.

Anthropometry↗

PubMedDate not supplied

[Tuberculosis in children in the early 90's].

The natural history of tuberculosis was re-examined, and especially the relation between contagion and first infection on one side and, on the other, primary tuberculosis (in children) and secondary tuberculosis in adult. With regard to the primary tuberculosis, the different clinical pictures were taken into consideration and it was reported how symptoms change as years go by (see miliary tuberculosis). As for the diagnostic aspect the importance of a quantitative interpretation of Mantoux reaction, was emphasized. In the final judgement, all factors that may change the results can therefore by considered: from the intercurrent viral infection to the patient's age, to the spreading of atypical mycobacteria in that area. The screening performed with the multi-injections technique is necessary to control the diffusion of the infection in the general population. In Italy, 1-2% of children aged 6 to 14 years old, are skin positive but the percentage varies widely in the different areas. However, it was higher than that observed in other European countries and far from the 1% incidence for 14 year olds, as hoped by the World Health Organization. After re-examining the characteristics of the four most important anti-tubercular drugs with particular attention to possible hepatotoxic effects of the isoniazid-rifampicin association, the authors analyses new therapeutic strategies, especially the one that tends to shorten treatment periods. This approach is effective in adults but has not yet been definitively confirmed in children. The surgical approach is more standardized in superficial adenitis where extirpation is indicated in atypical mycobacteria infections rather than in those due to Koch's bacillus. As far as indications of chemoprophylaxis are concerned it would seem that an international arrangement has now been reached that on the whole extends the indications to this type of treatment. The only uncertainty is whether adults, with intradermal reactions to tuberculin should undergo chemoprophylaxis if the time of contagion is unknown and the subject does not show any particular risk factors. On the grounds of data from literature, the results of vaccination are contrasting. Many factors could be responsible for this, especially the use, till a few years ago, of a non-standardized vaccine. However, vaccination remains an efficient method in populations at risk, listed in Italian law too. Nevertheless, according to the law, the subjects who would most benefit by vaccination are excluded (children under the age of 5 years and over the age of 15 years). However vaccination is getting less important in the general population.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1989

[Acute appendicitis, echographic findings].

A case of acute appendicitis in which an appendicolith was present is described. The diagnosis was made by plain abdominal radiography and ultrasound, and was confirmed at surgery. The plain abdominal film showed a lamellated, round calcification, projecting over the right iliac wing. Ultrasound revealed a tubular, hypoechogenic structure, containing an oval hyperechogenic area with acoustic shadow. The recent literature was reviewed, and the "graded compression" technique is described. A summary is given of the ultrasound findings of acute appendicitis, and of its most important differential diagnoses in childhood: mesenterial adenitis, and--less frequently--terminal ileitis.

Acute Disease↗

PubMed1989

[Chronic septic granulomatosis. Clinical and therapeutic aspects].

Chronic granulomatous disease of childhood is characterized clinically by the occurrence of severe and recurrent bacterial and fungal infections. The underlying biologic anomaly is defective microbicidal capacity of phagocytic cells with an abnormal oxidative response during phagocytosis. In most instances, inheritance is recessive and X-linked. Purulent adenitis and skin infections are the most common manifestations, but the overwhelming majority of deaths are caused by pulmonary aspergillosis, abscesses of the liver, and Salmonella infections. The most frequently recovered microorganisms include staphylococci, Aspergillus, Salmonellae, and Gram-negative rods. Bacterial infections seem to be considerably less frequent in patients under long-term prophylactic treatment with the trimethoprim-sulfamethoxazole combination. However, no oral antifungal agent is as yet available for the prevention of pulmonary aspergillosis, as ketoconazole has proved ineffective.

Child↗

PubMed1989

Fine needle aspiration biopsy cytology in diagnosis of salivary gland tumours.

Fine needle aspiration biopsy cytology of salivary gland tumours was performed in 97 patients. Histological confirmation was available in all cases except 9 cases of sialo-adenitis which responded to antibiotics. Accuracy of cytological diagnosis in exact categorisation of benign and malignant tumours was 93.7% and 91.1% respectively. False negative was 4.1%. The overall accuracy was 95.8%. There was no false positive report. Exact classification of tumour was made in 94.1% cases, ie, 80 out of 85 tumours. No complication was encountered in this procedure.

Adolescent↗

PubMedDate not supplied

Traveler's diarrhea-I. Definition, etiology and epidemiology.

With the development of rapid and convenient means of transportation, several million persons travel from industrialized countries to developing countries every year. From USA alone, approximately 4 million persons visit Mexico annually. These travelers are at risk to develop several infections during their stay abroad, but the most commonly experienced illness is diarrhea. The attack rate of diarrhea in travelers may be as high as 25 to 50 percent; 30 percent of those who get diarrhea are ill enough to be confined to bed and another 40% have to change their scheduled travel plans. The disease affects all ranks and it has achieved worldwide fame by its several euphemisms. Various epithets used to describe this illness include GI trots, Aden gut, Barsa belly, Turkey trot, Delhi belly, Hongkong dog, Montezuma's revenge, gyppsy tummy and turista. There have been considerable advances in our understanding about the etiology and epidemiology of this disease in the last two decades and the purpose of this review is to highlight some of this new information.

Diarrhea↗

PubMed1989

Calcification of axillary lymph nodes following BCG vaccination.

Axillary lymph node calcification was found in 18 children following BCG vaccination. Five of these also had symptomatic adenitis. The calcifications involved one to four nodes and appeared as discrete, oval densities. They disappeared over the course of several months in three patients. No axillary lymph node calcification was seen on chest radiographs of 60 other children who had had BCG vaccination in the neonatal period.

Adolescent↗

PubMed1989

Bowel obstruction secondary to mesenteric cyst formation.

A rare cause of intra-abdominal obstruction, mesenteric cysts derive from lymphatic tissue. The differential diagnosis should include mesenteric cyst when the patient presents with a history of multiple episodes of partial small-bowel obstruction or with an asymptomatic abdominal mass. A year-old girl was brought to the Family Practice Center with episodic, sharp, nonradiating, left-sided, mid-upper-abdominal pain. Examination indicated a possible diagnosis of mesenteric adenitis. Due to variation in the signs and symptoms of the condition, it appears that the use of ultrasonography is the most effective, nonoperative method of evaluation. Ultrasonography appears to be the most effective, nonoperative method of evaluation. Surgery is the only definitive diagnostic and therapeutic modality.

Child, Preschool↗

PubMed1989

Serological survey of measles in Yemen in 1985.

The HI assay for measles was used to evaluate the sera of 191 children of preschool age (1-6 ys) from five regions of South Yemen: highland, coastal, Vadi Hadramot, the agricultural area Abijan and the capital city Aden. The serum positivity rate was 47.5% in 1-2-year-old children, 75.5% in 3 year-old and 88.5% in 4-6 year-old children. The geometric mean of HI titres was 4.8 log2 in preschool children. An optimal strategy of vaccination against measles in Yemen is discussed.

Age Factors↗

PubMed1989

[Tracheobronchial tuberculosis observed from the chest X-ray findings and its pathogenesis].

Twelve cases of tuberculous tracheobronchitis were identified by bronchofiberscopy out of 185 tuberculous patients, and they are classified into four groups based on the chest X-ray findings and its pathogenesis, Group 1 (two cases); extensive endobronchial tuberculosis without radiographically demonstrable lesion. Group 2 (three cases); endobronchial tuberculosis occurring in airway that drains a pulmonary cavity or active lesion. Group 3 (four cases); endobronchial tuberculosis occurring in minimal cases of tuberculosis with radiographically fibrocaseous or fibroproductive type lesions. Group 4 (three cases); invasion of bronchus by perforation of hilar tuberculous adenitis. This classification would undoubtedly be better to understand tuberculous involvement of the bronchial tree than those previously reported classifications based on the bronchoscopic findings and clinical symptoms. Furthermore, it was found that the extent of the lung lesions showed no relation with the incidence of tuberculous tracheobronchitis. There is some differences among these four groups in terms of chest roentgenographic features, clinical symptoms and bronchoscopic findings. However, the presence of the third group has not been clearly recognized, as such type of the disease believed to exist in cases with extensive pulmonary involvement. Characteristics of the third group are mild clinical symptoms, inactive radiographic appearances and insidious clinical course, and most such cases are detected by the mass survey, and the diagnosis can be made only by endoscopic examinations. The incidence of tracheobronchial tuberculosis in our clinic was 6.5%, and that of the fourth group was 1.6%. Brief discussion was made on the endoscopic classification, pathogeneses, endoscopic changes during the course of chemotherapy and management of bronchial stenosis.

Adult↗

PubMed1989

[Apropos of 45 cases of cutaneous tuberculosis in Tlemcen (western Algeria)].

The cutaneous tuberculosis (CTB) is still frequent in Algeria. From March 81 through December 87, forty-five cases were observed in our service of Dermato-Venereology (CHU Tlemcen), something like 6.4 cases per year. The two sexes are equally represented; 66.6% aged under 40; 66.6% are living in cities and have modest social and economical conditions; 20% were inoculated with BCG; previous CTB (personal 8.8% of family 11.1%) were hardly seen. It took some 44% of the patients less than a year to ask for a diagnosis, after receiving several non specific treatments. The rest took longer to come for consultation and in one case, the disease evaluated for 28 years. One explanation is that sometimes the affection causes very little annoyance. The clinical aspects observed were often evocative: Lupus vulgaris, 28.8%, scrofuloderma, 28.8%, specific adenitis, 13.3%, tuberculosis verrucosa cutis, 13.3%, gum, 13.9%, ulcerous CTB, 2.2%. Tuberculin skin test was positive for 86% of the cases and was taken into consideration when it reaches over 15 mm (46%), and with discomfort (4.4%). The treatment was efficient in the large majority of the cases. However, 29.5% of the patients gave up before the end of the cure. We insist upon the priority of the relationship doctor-patient in the case of a chronicle affection, which is less uneasy for some and shameful for a great many.

Adolescent↗

PubMed1989

Serological survey of rubella in Yemen in 1985.

476 sera from subjects of 6 age groups were investigated using the HI test for rubella, the sera originating from 5 distinct regions of Yemen, namely highland, coastal the agricultural area Abijan, Vadi Hadramot and the capital Aden. The positivity rate among children aged 1-6 ys was 46.2%, the values obtained for girls aged 15-18, women in the 19-24 and 25-29 ys age group being 81%, 86.3% and 89.9%, respectively. When the findings of the immunological survey were evaluated with respect to the five different regions studied, the positivity rate in the highlands was found to be significantly higher among girls under 18 ys of age. The geometric means of HI titres for rubella antibodies proved to be the lowest in 1-3-year-old children (1: 59) and the highest in girls aged 15-18 ys (1: 163). The authors discuss the comparatively high risks of contracting rubella during pregnancy in four regions of Yemen.

Adolescent↗

PubMed1985

Peripheral lymphadenopathy in Nigeria.

An analysis of 294 enlarged peripheral lymph node biopsies in Ife, Nigeria, revealed that the underlying disease in 51.7% was chronic inflammation while malignant diseases accounted for 48.3%. The order of frequency of the lesions was reactive hyperplasia (29.3%), metastatic cancer (24.5%), malignant lymphoma (23.8%), tuberculosis (15.6%) and toxoplasmosis (3.7%). One-third of the metastases were of undetermined origin. The neck which accounted for 53% of the biopsies, was the most frequent site for tuberculous adenitis, toxoplasmic lymphadenitis, and malignancies. The axilla was involved in 15% of the cases and was the most common site for metastatic breast carcinoma. The inguinal lymph nodes were also involved in 24% of the cases and had the highest occurrence of melanoma, reactive hyperplasia and parasitic granuloma. The habit of bare-foot walking leading to repeated trauma and infection is implicated in the high incidence of inguinal node reactive hyperplasia. This study demonstrates that lymph node malignancies and chronic granulomatous infections present a problem of increasing diagnostic and therapeutic importance and furthermore, it emphasizes that physicians in Nigeria should consider toxoplasmosis in the differential diagnosis of peripheral lymphadenopathy.

Adult↗

PubMed1988

Yersinia enterocolitica.

In Europe and North America, Yersinia enterocolitica has been reported with increasing frequency in recent years as a cause of diarrhea, mesenteric adenitis, terminal ileitis, and other clinical syndromes. Yersiniosis, with its protean manifestations, may occur as an endemic disease or in epidemics in communities, families, schools, or hospitals. The clinical and epidemiologic features of this disease are reviewed, as are aspects of its pathogenesis, diagnosis, treatment, and prevention.

Child, Preschool↗

PubMed1977

C-reactive protein in streptococcal pharyngitis.

This study was designed to explore whether the test for C-reactive protein (CRP) is useful in differentiating bona fide streptococcal infection from the symptomatic carrier at the time of the acute visit to the physician. Serial blood samples from 157 children with symptomatic pharyngitis and a positive culture for group A streptococci were analyzed for the presence or absence of CRP. These data were compared with the patients' antibody responses to two streptococcal extracellular antigens (antistreptolysin O and antistreptococcal deoxyribonuclease B). Seventy-eight percent of patients with serologically confirmed streptococcal pharyngitis had a positive CRP test at the initial visit. Conversely, if the CRP test was negative at the acute visit, only about 25% later showed an antibody response. This latter finding held regardless of the degree of positivity of the initial culture, the presence of exudate or adenitis, or the presence of a temperature greater than 38.3 C (101 F) or coryza. These data suggest that the CRP test may be helpful to the clinician, especially if this abnormal protein is absent at the time of the acute visit.

C-Reactive Protein↗

PubMed1987

[Respiratory infectious diseases in horses].

Among all infectious diseases affecting horses, respiratory disease pose the greatest threat to horses kept in stables, horses used for breeding and race horses. Here a distinction should be made between the so-called monocausal infectious diseases (so-called Henle-Koch postulates) and multicausal infectious diseases which are the result of the synergistic interaction of different processes, that alone do not lead to disease. There is no clearcut distinction between the two groups. The most important monocausal respiratory infections of horses are caused by equine influenza virus (subtypes 1 and 2), equine rhinopneumonitis virus (equine herpes-virus type 1), equine arteritis virus and partially by Reoviruses. In addition, streptococcus equi (strangles, adenitis equorum, coryza contagiosa equorum) and mycobacteria tuberculosis can cause monocausal diseases. In multicausal infections, the first step usually is a virus infection. This is the basis for secondary infection by widespread, opportunistic agents such as bacteria, mycoplasms or fungi which lead to clinical disease. The method of choice for controlling monocausal respiratory infections of horses is prophylactic vaccination and chemotherapy. Measures to control multicausal infections include: vaccination with functional-synergistic combined vaccines; the use of herd-specific vaccines; medical stimulation of the non-specific part of immunity (immunmodulation, paramunization). Paramunization is a new concept in the prophylaxis and therapy of respiratory infections of horses and can be combined with prophylactic vaccination as well as with chemotherapy. In severe cases of respiratory disease paramunization can also be combined with corticosteroids.

Animals↗

PubMed1987

Abdominal tuberculosis in children. A survey of cases at the Red Cross War Memorial Children's Hospital, 1976-1985.

Fifty-nine cases of abdominal tuberculosis were seen at the Red Cross War Memorial Children's Hospital, Cape Town, during the period 1976-1985. More than half these patients were under 4 years of age and all were malnourished. Mesenteric adenitis and/or peritoneal involvement accounted for the majority of cases and only 8 patients with proven gastro-intestinal lesions were seen. The diagnosis of suspected abdominal tuberculosis is relatively easily made since abdominal distension occurs in almost all patients. More than half have an abdominal mass, a chest radiograph suggestive of tuberculosis, a positive Mantoux skin test or a combination of these as supportive evidence for the diagnosis. Over a quarter of the patients presented with signs suggestive of intestinal obstruction. Response to antituberculosis therapy is excellent. Stricture formation on healing may occur in a minority of patients with the enteric form of the disease. Providing it is not part of disseminated tuberculosis in a grossly malnourished young child, the prognosis with treatment for abdominal tuberculosis is satisfactory.

Age Factors↗

PubMed1979

Human gastrointestinal infections by Yersinia enterocolitica.

In an average-sized peripheral hospital in Belgium, Y. enterocolitica has been isolated from 1.1% of stool cultures, using an unmodified routine technique. In a group of unselected patients undergoing appendicectomy, 1.3% of patients had a positive culture, either from the mesenteric lymph nodes or the appendix, or from both sources. In the same group of patients, 1.7% of cultures grew a Salmonella. In more than half of the patients, the diagnosis of mesenteric adenitis was made during the surgical intervention. The clinical picture of Yersinia infection was greatly influenced by the age of the patients. Bacteriological (serotypes, antibiotic sensitivity, associated enteric pathogens), epidemiological (sex distribution, seasonal influence and secondary infection among family contacts) and clinical data confirm previous experience with human yersiniosis in this country.

Adolescent↗