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Volume 81 | Number 2 | May - June - July - August 2018
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114
AWARD WINNING REPORT
First report of decreased DNA methylation of the Alpha- subunit of the interleukin-2 receptor (IL2RA) gene promoter region in children and adolescents with autoimmune thyroid disease.
Ioannis Kyrgios, Aikaterini Fragou, Eleni P. Kotanidou, Konstantina Mouzaki, Smaragda Efraimidou, Georgios Tzimagiorgis, Assimina Galli-Tsinopoulou
124
RECENT DECLARATION
Endorsement of Budapest Declaration: Rights, Health & Well-Being of Children and Youth on the Move
Stauroula Papadakou, Stella Tsitoura
132
RESEARCH STUDY
Effects of hydrotherapy - Halliwick in the respiratory system of children with cerebral palsy
Christodoulaki Euanthia, Hristara-Papadopoulou Alexandra, Chandolias Konstantinos
142
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Completed suicide in prepubertal children (≤12 years old)
Antonios Paraschakis
152
Glucose-6-phosphate dehydrogenase deficiency (G6PD), drugs and substances contradicted in disease patients
Triantafyllia Sdogou, Kleopatra Schulpi
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Ovarian cysts in infancy and childhood: options of treatment Kanioura Eftychia, Kalogridaki Evgenia, Skondras Ioannis, Methymaki Areti-Alexandra, Kapouleas Georgios, Passalidis Alexandros
172
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Congenital Melanocytic Nevus: A case study F. Balomenou, T. Palianopoulos, A. Drougia, I. Basoukas, G. Gaitanis, V. Giapros
178
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First report of decreased DNA methylation of the Alpha- subunit of the interleukin-2 receptor (IL2RA) gene promoter region in children and adolescents with autoimmune thyroid disease
Ioannis Kyrgios, Aikaterini Fragou, Eleni P. Kotanidou, Konstantina Mouzaki, Smaragda Efraimidou, Georgios Tzimagiorgis, Assimina Galli-Tsinopoulou
Abstract
Background: Alpha- subunit of the interleukin-2 receptor (IL2RA) is involved in the regulation of T-cell function and has been previously related with autoimmune thyroid disease. However, the exact processes at a molecular level are not fully known. Epigenetic modifications such as DNA methylation in gene promoters are considered as possible mechanisms.
Ioannis Kyrgios
Eleni P. Kotanidou
Konstantina Mouzaki
Assimina Galli-Tsinopoulou
4th Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
Aikaterini Fragou
Georgios Tzimagiorgis Laboratory of Biological Chemistry, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
Smaragda Efraimidou Hematology Laboratory, Papageorgiou General Hospital, Thessaloniki, Greece
Aim: To investigate whether there are differences in the percentage of DNA methylation within the IL2RA gene promoter in children and adolescents with autoimmune diseases of the thyroid gland.
Materials and Methods: In the present study, 130 participants were enrolled: 53 patients with Hashimoto thyroiditis (11.7±0.3 years), 21 patients with type 1 diabetes and Hashimoto thyroiditis (13.8±0.5 years), 8 patients with Graves disease (12.0±0.4 years) and 48 healthy controls (11.1±0.3 years) without any personal/ family history of thyroiditis/ other autoimmune condition. DNA was extracted from whole blood and then modified with sodium bisulfite. The percentage of methylation in the IL2RA gene promoter was later quantified, using specific primers for modified DNA, by Real-Time PCR, and melting-curve analysis of the selected fragment. Results: Percentage of methylation in the IL2RA gene promoter was found to significantly differ among the study groups (p<0.001) and was significantly decreased in patients with Graves’ disease (25.1±4.6%) but not in those with Hashimoto thyroiditis (37.4±1.3%) in comparison with controls (42.1±1.5%).
Conclusions: Decreased DNA methylation of the IL2RA gene promoter may be related with increased expression of the corresponding gene product, thus contributing to aetiopathogenesis of the autoimmune thyroid disease especially Graves disease in childhood and adolescence.
Key words: DNA methylation, children and adolescents, IL2RA, autoimmune thyroid disease
θυρεοειδικής νόσου (9,10) έχει συμβάλει ώστε
SEGA (SECA 711, Germany)
Harpenden (HARPENDEN, Veeder-Root, Elizabethtown, NC, USA),
(https://zscore.research.chop.edu/).
(Chemiluminescent Immunoassay System)
Immulite® 2000 της Diagnostic
TSH (TSI).
QIAamp
(Real-Time PCR) (Step One Plus Real-Time PCR System, Applied Biosystems).
(melting curves)
DNA (22).
(υπερμεθυλιωμένο) (31). Επιπρόσθετα, οι Limbach και
DNA
CD8+ T-κύτταρα,
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Endorsement of Budapest Declaration: Rights, Health & Well-Being of Children and Youth on the Move
ALAPE-Latn American Association of Pediatrics
ECPCP-European Confederation of Primary Care Pediatricians
EAP-European Academy of Pediatrics
German Academy of Pediatrics and Adolescent Medicine-DAK German Professional Association of Paediatricians
German Society of Pediatrics
German Society of Tropical Paediatrics and International Child Health (GTP)
Hungarian Paediatric Association
Japan Society for Social Medicine (JSSM) Spanish Society of Pediatrics
Swiss Society of Pediatrics (SSP) International Child Health Group (IHCH)
Water Orientation Test Alyn 1 (WOTA1)
Water Orientation Test Alyn 2 (WOTA2).
e-mail: konchand@gmail. com
Correspondence
Dimitriou Nika 12
Katerini, 601 34
Τ. 6947-476006
e-mail: konchand@gmail. com
Christodoulaki Euanthia, Hristara-Papadopoulou Alexandra, Chandolias Konstantinos
Abstract
Purpose: The purpose of this research is to study the effects of hydrotherapy on the respiratory system of children diagnosed with Cerebral Palsy. The results of hydrotherapy on the musculoskeletal system of children with Cerebral Palsy has been extensively studied and reported in various research papers, as well as the results of hydrotherapy on the respiratory system and the lung function of children with cystic fibrosis, asthma, scoliosis etc. However, few are the studies that report the effects of hydrotherapy on the respiratory system of children with Cerebral Palsy.
Methodology: This study includes ten (10) children diagnosed with cerebral palsy, aged from five (5) to fifteen (15) years old. Children enrolled in the hydrotherapy program once a week for 45 minutes. The function of their respiratory system was measured by spirometer, flowmeter and oximeter. Furthermore, the International Halliwick Association’s SWIM evaluation form has been completed by the researcher. This form evaluates the respiratory control of each individual inside the water. In addition, two more evaluation forms have been completed by the researcher, the Water Orientation Test Alyn 1 (WOTA1) and the WATER Orientation Test Alyn 2 (WOTA2). Both measurements and evaluations were repeated twice during the investigation. A pre-test was conducted at the beginning of the program and a post-test at the end of the program. Results: Eight (8) children have successfully completed the study, whereas one (1) child has been excluded due to an allergic reaction and another one (1) couldn’t complete the study. The results indicate changes in the lung function, but no statistically significant differences were observed after the thorough evaluation of the questionnaires.
Conclusion: Hydrotherapy resulted in positive effects on the respiratory system of children with Cerebral Palsy. Nevertheless, further investigation is required to test the effectiveness of hydrotherapy after a longer time period than the one currently studied.
Key words: cerebral palsy, hydrotherapy, therapeutic swimming, Halliwick, lung diseases, Water Orientation Test Alyn 1 (WOTA1), Water Orientation Test Alyn 2 (WOTA2), Swim Test.
Christodoulaki Euanthia
Hristara-Papadopoulou
Alexandra
Chandolias Konstantinos
Pediatric Physiotherapists
(18).
1. Ασκήσεις ενδυνάμωσης
2. Διατατικές ασκήσεις
3. Αναπνευστικές ασκήσεις
4. Ασκήσεις
5. Εκπαίδευση βάδισης
6. Χαλάρωση (18,20)
1.
2.
3.
4.
5.
6.
8.
Halliwick
(7). (www.halliwick.org.gr, 2016).
1.
2.
3.
4.
5.
6.
7.
8.
9.
1.
2.
3.
1. Ακτινογραφίες
2. SaO2
3. Καλλιέργεια
4. Μέτρηση FEV1
5. Μέτρηση PEFR (21)
(PEFR).
SWIM
Ιnternational Halliwick Association
φόρμες Water Orientation Test Alyn 1 (WOTA1) και Water Orientation Test Alyn 2 (WOTA2).
(SPO2post=97,12),
Paired Samples Statistics
Pair 1 HRpre HRpost
Pair 2 SPO2pre SPO2post
Pair 3 PEFRpre PEFRpost
Pair 4 FEV1pre FEV1post
Pair 5 FEV1Ppre FEV1Ppost
Paired Samples Correlations
Pair 1 HRpre & HRpost
Pair 2 SPO2pre & SPO2post
Pair 3 PEFRpre & PEFRpost
Pair 4 FEV1pre & FEV1post
Pair 5 FEV1Ppre & FEV1Ppost
HRpre - HRpost Pair 1
SPO2pre - SPO2post Pair 2
PEFRpre - PEFRpost Pair 3
FEV1pre - FEV1post Pair 4
FEV1Ppre - FEV1Ppost Pair 5
Προτάσεις
1. Bax Martin, Brown Keith,
2009:9-14
2. Blair Eve, Stanley Fiona, Issues in the Classification and Epidemiology of Cerebral Palsy. Article in Mental retardation and developmental disabilities reviews, January 1997: 1-2. Developmental Medicine and Child Neurology, 2005:838-842
3. Dragos Adrian, Emese Agnes, Beng Ileana, Effects Of An Aquatic Therapy Program On Vital Capacity, Quality Of Life And Physical Activity Index In Children With Cerebral Palsy, Human And Veterinary Medicine, 2013, Vol. 5, Issue 3: 117-124.
4. Ersoz Murat, Selcuk Barin, Gunduz Ramazan. Kurtaran Aydan, Akyz Mufit, Decreased Chest Mobility in Children With Spastic Cerebral Palsy, The Turkish Journal Of Pediatrics, 2006, 48:344-350
5. Frazen Kathleen, Tryniszewski Priscilla, Effectiveness of Aquatic Therapy for Children with Neurodevelopmental Disorders: A Systematic Review of Current Literature, May 2013: 1-22
6. Grosse J. Susan, Water Freedom For All: The Halliwick Method, International Journal Of Aquatic Research And Education, 2010
7. Halliwick Association of Greece Ελληνικό Σωματείο Halliwick Therapy (www.halliwick.org. gr, 2016)
8. Hutzler Yeshayahu, Chacham Anat, Bergman Uri, Effects of a movement and swimming program on vital capacity and water orientation skills of children with cerebral palsy, Neurodevelopmental Medicine and Child Neurology, 1998: 176-181
9. JorgicBojan, Dimitrijevic Lidija, Lambeck Johan, Aleks and rovic Marko, Okicic Tomislav and Madic Dejan, Effects of aquatic programs in children and adolescents with cerebral palsy: Systematic review, Sport science 5, 2012: 49-56
10. Park Sook Eun, Park Hyun Jung, Rha Wook Dong, Park IL Chang, Park Woo Change, Comparison Of The Ratio Of Upper To Lower Chest Wall In Children With Spastic Quadriplegic Cerebral Palsy And Normally Development Children, Yonsei Medical Journal, 2006, Volume 47, No 2:237-242
11. Pickham-Fragala Maria, Haley M. Stephen, O’Neil E. Margaret, Group Aquatic Aerobic Exercise For Children With Disabilities, Developmental Medicine And Child Neurology, 2008, 50: 822-827.
12. Retarekar Runzun, Pinkham-Fragala A. Maria, Townsend E. Elise, Effects Of Aquatic Aerobic Exercise For A Child With Cerebral Palsy: Single - Subject Design, Pediatrics Of The Ameri-
can Physical Therapy Association, 2009:336-344.
13. Rosenbaum L. Peter, Jacobson Bo, Domino Diane, Proposed definition and classification of cerebral palsy, April 2005- Introduction. Article in Developmental Medicine and Child Neurology, August 2005: 571
14.
15.
2010: 9-10
16. Παντελιάδης Π. Χρήστος, Συχνότητα - Επιδημιολογία,
Halliwick
Mαϊου 2016, Makedonia Palace, Θεσσαλονικη 20. Χριστάρα-Παπαδοπούλου
6877706892
e-mail: antparaschakis@ yahoo.gr
Correspondence
Antonios Paraschakis
95, Ioanninon Str 16674 Glyfada, Attica
T. +30210 9636097
+306877706892
e-mail: antparaschakis@ yahoo.gr
Antonios Paraschakis
Abstract
It is widely believed that suicides in prepubertal children (≤12 years old) are underreported for various reasons (stigma and erroneous attribution to accidents being the main ones). Personal and/or family history of depression, bipolar disorder, schizophrenia, attention-deficit disorder, suicide/suicide attempts, symptoms such as (commanding) auditory hallucinations, delusional ideas, anhedonia, hopelessness, dreams and persistent preoccupation about death, family discord, divorce, family grief, physical and/or sexual abuse, bullying, school failure, extreme poverty, all seem to be –more or less- related to completed suicide in prepubertal children. In comparison to teenagecompleters, the younger ones appear to suffer less from drug abuse and alcohol problems (or psychiatric morbidity in general). Erotic/romantic relations seem to be also less of a problem for younger completers, whose main problems appear to be predominately confined at home or at school. Children of 12 years will very rarely express their suicidal ideation to anyone. Pediatricians may well be the first -and often the only- capable of pinpointing the “vulnerable” children, given that a child-mental health expert might be totally unavailable in certain hospital settings. (S)he has to maintain a high level of suspicion particularly in cases of “equivocal” accidents (e.g. cutting by sharp objects, falling from heights, poisoning etc.), investigate whether any of the risk factors are present and interview the child (preferably alone). Prepubertal suicide completers were usually isolated, silent and helpless. Aim of the review was to raise the awareness of pediatricians in order to assist the vulnerable children before it is too late…
Key words: suicide, children, childhood, preadolescent, prepubertal
Antonios Paraschakis
Psychiatric Hospital of Attica “Dafni”, Athens, Greece
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34. Orbach I, Feshbach S, Carlson G, Glaubman H, Gross Y. Attraction and repulsion by life and death in suicidal and in normal children.J Consult Clin Psychol 1983;51:661-70.
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36. Klimes-Dougan B. Screening for suicidal ideation in children and adolescents: methodological considerations. J Adolesc1998;21:435-44.
37. Kennedy SP, Baraff LJ, Suddath RL, Asarnow JR. Emergency department management of suicidal adolescents. Ann Emerg Med 2004;42:452-60.
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e-mail: lsdogou@writeme. com
Correspondence
Triantafyllia Sdogou
Thinon & Papadiamantopoulou, 115 27 Goudi, Athens
Τ. +302107467476
Κ. +306934135413
e-mail: lsdogou@writeme. com
Triantafyllia Sdogou, Kleopatra Schulpi
Summary
Erythrocyte G6PD deficiency is inherited with x-linked recessive trait. High prevalence of G6PD deficiency has been described in Greece. Clinical manifestations are presented when the patients are administrated with drugs and substances named in a special list (table 1). The clinical manifestations include jaundice (with high indirect bilirubin), haemolysis and anaemia.
Neonatal screening includes the measurement of G6PD activity in dried blood spots on Guthrie cards. If the results are positive, quantitation of the enzyme activity should confirmed at the age of 6 months. The high prevalence of the disorder in the Greek population obliged the physicians and paediatricians to be informed about the activity of the enzyme and be careful before administration of any drug. G6PD activity is measured during the perinatal period, as mentioned above and it has been incorporated in the Greek neonatal screening.
Key words : G6PD, hemolytic anemia, kuamism, neonatal jaundice, contraindicated drugs
Triantafyllia Sdogou
Unit for Metabolic Disorders, Choremio Research Institute, First Department of Pediatrics School of Medicine, National and Kapodistrian University of Athens, “Agia Sofia” Children’s Hospital, Greece
Kleopatra Schulpi
Inborn Errors of Metabolism Department, Institute of Child Health, “Agia Sofia” Children’s Hospital, Athens, Greece
Εικόνα 1
(Glucose6-phosphate dehydrogenase)
http://www.ich.gr).
(2-amino-5 sylphanyltheiazole)
(Azatadine)
(Acetaminophenone)
(Acetanilide)
(Acetophenetidine)
(AcetylSalycilic Acid)
(Acetylphenylhydrazine)
(Actazoline) Σουλφαμίδια (Sulphamides)
(Aminopyrine)
(Antihistaminic)
(Analgesic)
(Analgesic)
(Analgesic)
(Antimicrobial)
(Analgesic)
Αμινοφαιναζόνη (Aminophenazone)
Ανταζολίνη (Antazoline)
Αντιισταμινικά (Antihistamines)
Αρσίνη (Arsine)
Ασκορβικό Οξύ-Βιταμίνη C (Ascorbic Acid-Vitamin C)
Αστεμιζόλη (Astemizole)
Βενζεόλη (Benzehol)
Βερβερίνη (Berberine)
Βιταμίνη Κ (Vitamin K)
Βρωμοφαινιραμίνη (Brompheniramine)
Γλιβενκλαμίδη (Glibenclamide)
Δαντρολένιο (Dantrolene sodium)
Δαψόνη (Dapsone)
Δεξχλωρφενιραμίνη (Dexchlorpheniramine)
Δεφεροξαμίνη (Desferioxamine)
Διαμίνη-διφαινυλοσουλφόνη (Diamino-diphenylosulphone)
Διμεθινδένη (Dimentindene)
Διμεκαρπρόλη (Demerkaptole)
Διμερκαπρόλη (Dimercaprol)
Διπυρόνη (Dipyrone)
Αναλγητικά (Analgesic)
Αντιισταμινικά (Antihistamines)
Αναλγητικά (Analgesic)
Βιταμίνες (Vitamins)
Αντιισταμινικό (Antihistaminic)
Αντιδιαβητικά (Anti-diabetic)
Αντιισταμινικά (Antihistaminic) Αντιδοτο
Αντιμικροβιακά (Antimycobacterial)
Αντιισταμινικό (Antihistaminic)
Χηλικά σιδήρου
Σουλφόνες (Sulphones)
Αντιισταμινικά (Antihistaminic)
Αντίδοτα (Antidotes)
Αναλγητικά (Analgesic)
Διφαινυδραμίνη (Dephenylydramine)
Διφαινυδραμίνη (Diphenhydramine)
Δοξορουβικίνη (Doxorubicin)
Εβαστίνη (Ebastine)
Εναλαπρίλη (Enalapril maleate)
Θειαζουλουλφόνη (Theiazosulphone)
Ισοβουτιλικό
(Isobutyl nitrite)
Ισονιαζίδη (Isoniazide)
Καπτοπρίλη (Captopril)
Κινακρίνη (Quinacrine)
Κινιδίνη (Quinidine)
Κινίνη (Quinine)
Κινολόνες (Quinolones)
Κινοξασίνη (Cinoxacin)
Κινοσίδη (Kinoside)
Κολχικίνη (Colchicine) Κυπροεπταδίνη (Cyproheptadine) Λοραταδίνη (Loratadine) Μεθυλντόπα (Methyldopa)
Μεκουιταζίνη (Mequitazine)
Αντιισταμινικό (Antihistaminic)
Χημειοθεραπευτικά (Antineoplastic)
Αντιισταμινικά (Antihistaminic)
Εναλαπρίλη (Enalapril maleate)
Αντιμικροβιακά (Antibacterial)
Νιτρώδη (Nitrates)
Αντιμικροβιακά (Antibacterial)
Αντιυπερτασικά (Hypertention)
Ανθελονοσιακά (Antimalarial)
Ανθελονοσιακά (Antimalarial)
Ανθελονοσιακά (Antimalarial)
Αντιβιοτικά (Antibiotics)
Κινολόνες (Quinolones)
Αντιδραστήρια (Gout Preparations)
Αντιισταμινικά (Antihistaminic)
Αντιισταμινικό (Antihistaminic)
Αντιυπερτασικά (Antihypertensives)
Αντιισταμινικό (Antihistaminic)
Μπλε
Ενεργή
Μεναπθόνη (Menaphthone)
Μεπακρίνη (Mepacrine)
Μεστρανόλη (Mestranol)
Μεταμιζόλη (Metamizole)
Μετφορμίνη (Metformin)
(Tolouidine Blue)
Μπλέ
(Methylene blue)
Ναλιδικό οξύ (Nalidixic Acid)
Ναφθαλίνη (Napthalene)
Ναφθόλη (β-Naphthol)
Νιριδαζόλη (Niridazole)
Νιτρίλιο αμυλίου (Amyl nitrite)
Νιτροφουραζόνη (Nitrofurazone)
Νιτροφουραντοϊνη (Nitrofurantoin)
Νιτρώδες Νάτριο (Sodium nitrite)
Νιφουροξαζίδη (Nifuroxaside)
Νοροφλοξασίνη (Norfloxacin)
Οξατομίδη (Oxatomide)
Ουρικό οξύ (Uric Acid) Οφλοξασίνη (Ofloxacin)
Αιμοστατικά (Prothrombogenic)
Ανθελονοσιακά (Antimalarial)
Αντισυλληπτικά (Hormonal Contraceptives)
Αντιδιαβητικά (Antidiabetics)
Αντιδραστήρια (Gout Preparations)
Αντιδραστήρια (Gout Preparations)
Κινολόνες (Quinolones)
Ανθελμινθικά (Anthelmintics)
Ανθελονοσιακά (Antimalarial)
Αντιδότο (Antidote)
Νιτροφουράνια (Nitrofurans)
Νιτροφουράνια (Nitrofurans)
Αντιδότο (Antidote)
Αντιδιαρροϊκά
Κινολόνες (Quinolones)
Αντιισταμινικά (Antihistaminic)
Κινολόνες (Quinolones)
Παμακίνη (Pamaquine)
Παρα-
(Para-amino benzoic acid)
Παρα-
(Paraminosalycilic Acid)
Παρακεταμόλη (Paracetamol)
Πεντακίνη (Pentaquine)
Πριμακίνη (Primaquine)
Προβενεσίδη (Proveneside)
Προγουανίλη (Proguanil)
Προμεθαζίνη (Promethazine)
Πυρινεθαμίνη (Pyrinethamine)
Ρασμπουρικάση (Rasburicase)
Σαλισιλαζοσουλφαναμίδη (Salisylazosulphanylamide)
Σελεκοξίμπη (Celecoxib)
Σετιριζίνη (Cetirizine)
Σιπροφλοξασίνη (Ciprofloxacin)
Σουλφαδιαζίνη (Sulphadiazine) Σουλφαζογουανιδίνη (Sulphazoguanidin)
Σουλφακιτίνη (Sulphacitin)
(Sulphamethoxazole)
Σουλφαμεθοξυπυριδαζίνη (Sulphamethoxypyridazine)
(Analgesic)
Αναλγητικά (Analgesic)
Ανθελονοσιακά (Antimalarial)
Ανθελονοσιακά (Antimalarial) Νεφρολογικά
Ανθελονοσιακά (Antimalarial)
Αντιισταμινικά (Antihistaminic)
Χημειοθεραπευτικά (Antineoplastic)
Αντιμικροβιακά (Antibacterial)
Αντιφλεγμονώδη (Antiinflammatory)
Αντιισταμινικά (Antihistaminic)
Κινολόνες (Quinolones)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Ενεργή
Σουλφανιλαμίδιο (Sulphanilamide)
Σουλφαπυριδίνη (Sulphapyridine)
Σουλφισαξαζόλη (Sulphisaxazole)
Σουλφισοξαζόλη (Sulfisoxazole)
Σουλφοακεταμίδη (Sulphacetamide)
Σουλφοσόνη (Sulphosone)
Στιβοφαίνη (Stibophen)
Στρεπτομυκίνη (Streptomycin)
Σύμπλεγμα
(Menadione Na bisulfite)
Τερφεναδίνη (Terfenadine)
Τιαπροφανικό
(Tiaprofenic acid)
Τριβενζαμίνη (Tribenzamine)
Τριμεθοπρίμη (Trimethoprim)
Τρινιτροτολουένη (Trinitrotoluene)
Τριξεξυφαινιδύλη (Trixexyphenidyl)
Τριπελεναμίνη (Tripelennamine)
Υδραλαζίνη (Hydralazine) Υδροξυζίνη (Hydroxyzine) Υδροχλωρική
(Procainamide HCI)
(Toluene Hydrochloride)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Αντιμικροβιακά (Antibacterial)
Αντιελμινθικά (Anthelmintics)
(Antimicrobial)
(Vitamin K)
Αντιισταμινικά (Antihistaminic)
Αναλγητικα (Analgesic)
Αντιμικροβιακά (Antibacterial)
Αντιπαρκινσονικά (Antiparkinsonism)
Τριπελεναμίνη (Tripelennamine)
Αντιυπερτασικά (Antihypertensives)
Αντιισταμινικά (Antihistaminic) Αντιαρρυθμικά (Antiarrythmic)
Φαιναζοπυριδίνη (Phenazopyridine)
Φαινακετίνη (Phenacetine)
Φαινυλβουταζόνη (Phenylbutazone)
Φαινυλυδραζίνη (Phenylhydrazine)
Φαινυτοΐνη (Phenytoin)
Φλουοθάνη (Fluothane)
Φουραζολιδόνη (Furazolidone)
Φουραλταδόνη (Furaltadone)
Φουραλταδόνη (Furaltadone)
Φυτομεναδιόνη (Phytomenadione)
Χλωραμφενικόλη (Chloramphenicol)
Χλωρογουανιδίνη (Chloroguanidine)
Χλωροκίνη (Chloroquine)
Χλωροφαινιραμίνη (Chlorpheniramine)
L- ντοπα (L-Dopa)
Bitter mellon
Fava beans (κουκιά)
Lawsomia mermis (Henna)
Napthalene (Ναφθαλίνη)
Ουρολογικά (Genitourinary)
Νευροαναλγητικά
Αντιφλεγμονώδη (Antinflammatory)
Αιμολυτικά (Hemolytic)
Αντιεπιλεπτικά (Antiepileptic)
Αναισθητικά (Αnesthetic)
Νιτροφουράνες (Nitrofurans)
Νιτροφουράνες (Nitrofurans)
Νιτροφουράνες (Nitrofurans)
Αιμοστατικά (Prothrombogenic)
Αντιμικροβιακά (Antimicrobial)
Ανθελονοσιακά (Antimalarial)
Αντιισταμινικά (Antihistaminic)
Αντιεπιληπτικά (Anti-epileptic)
Tonic water
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21. Bertil Glader, MD, PhD up to date Literature review current through: Aug 2017. Diagnosis and management of glucose-6-phosphate dehydrogenase deficiency. This topic last updated: Aug 28, 2017.
e-mail:
Correspondence
Kanioura Eftychia
Alimountos 44, 16451, Argiroupoli Τ. 2109912124, 6993164232
e-mail: ekanioura@hotmail. com
Kanioura Eftychia, Kalogridaki Evgenia, Skondras Ioannis, Methymaki Areti-Alexandra, Kapouleas Georgios, Passalidis Alexandros
Summary
Ovarian masses are a rare case as far as children’s surgery is concerned. There has been a raise in the diagnosis during the last years due to the advances in imaging techniques. Aim of this study is to review and record the patients treated for ovarian masses in our department as well as to present the relative literature.
We collected all the patients of our department who were diagnosed with ovarian masses between the years 2004 - 2016. This cohort study consists of 41 patients whose average age was 107/12 years. Fourteen of them were premenarcheal girls and the rest 21 were menarcheal girls. Data was collected by reviewing the hospital’s medical archives.
Forty-one point five per cent of the patients presented with a simple ovarian cyst, 48,5% with a benign mass and 10% with a malignant mass. The most frequent symptom was abdominal pain. U/S imaging was the most helpful preoperative diagnostic tool followed by the measurement of α-FP, β-hCG and CA-125 (31 patients).
In conclusion, patients with ovarian masses mostly present with abdominal pain. This situation causes a dilemma in the differential diagnosis between ovarian mass and acute appendicitis, especially if the pain localizes in the right inguinal. When suspecting malignancy, cancer biomarkers should be investigated preoperatively. Finally, ovarian torsion is a medical emergency, which threatens the viability of the organ and should always be in the differential diagnosis.
Key words: Ovarian cyst, neonates, childhood
Kanioura Eftychia
Kalogridaki Evgenia
Skondras Ioannis
Methymaki Areti-Alexandra
Kapouleas Georgios
Passalidis Alexandros
Second surgical department of “P&A Kyriakou” Children’s Hospital
Βιβλιογραφία
1. Mukhopadhyay M, Shukla Rm, Mukhopadhyay B, Mandal KC, Ray A, Sisodiya, et al. Ovarian cysts and tumors in infancy and childhood. J Indian Assoc Pediatr Surg 2013;18(1);16-9.
2. Aydin BK, Saka N, Bas F, Yilmaz Y, Haliloglu B, Guran T et al. Evaluation and treatment results of ovarian cysts in childjood and adolescence: a multicenter, retrospective study of 100 patients. J Pediatr Adolesc Gynecol 2017;30;449-455.
3. Emeksiz HC, Derinöz O, Akkoyun EB, Pinarli FG, Bideci A. Age-specific frequencies and characteristics of ovarian cysts in children and adolescents. J Clin Res Pediatr Endocrinol 2017;9(1);58-62.
4. Shimada T, miura K, Gotoh H, Nakayama D, Masuzaki H. Management of prenatal ovarian cysts. Early Hum Dev 2008;84;417-420
5. Zhang M, Jiang W, Li G, Xu C. Ovarian masses in children and adolescents - an analysis of 521 clinical cases. J Pediatr Adolesc Gynecol 2014;27;73-77.
6. Llorens Salvador R, Sangüesa Nebot C, Pacheco Usmayo A, Picó Aliaga S, Garcés Iñigo E. Neonatal ovarian cysts: Ultrasound assessment and differenctial diagnosis. Radiologia 2017;59;3139.
7. Manjiri S. Padmalatha SK, Shetty J. Management of complex ovarian cysts in newborns – our experience. J Neonat Surg 2017;6:3
8. Brandt M, Luks F, Filiatrault D, Garel L, Desjardins J, Youssef S. Surgical indications in antenatally diagnosed ovarian cysts. J Pediatr Surg 1991;26;276-282.
9. Ki EY, Byun SW, Choi YJ, Lee KH, Park JS, Lee SJ et al. Clinicopathologic review of ovarian masses in Korean premenarchal girls. Int J Med Sci 2013;10;1061-1067.
10. Gonzalez D, Minneci P, Deans K. Management of benign ovarian lesions in girls: a trend toward fewer oophorectomies. Adolescent Pediat G 2017;29;1-7.
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12. Oltman S, Fischer A, Barber R, Huang R, Hicks B, Garcia N. Cannot exclude torsion-a 15year review. J Pediatr Surg 2009;44;1212-1217.
Correspondence
Vasileios Giapros
e-mail: vgiapros@cc.oi.gr
F. Balomenou, T. Palianopoulos, A. Drougia, I. Basoukas, G. Gaitanis, V. Giapros
Summary
By the term “Congenital melanocytic nevus”, CMN, we define the melanocytic lesion that is present at birth and will acquire a diameter equal to or bigger than 20 cm during adult life. Its incidence is estimated as 1 in 50000 births. In spite of its rarity, this lesion is important because it is related to severe complications, like affection of the CNS (neurocutaneous melanosis, NCM), cutaneous or extracutaneous melanoma and its impact on the patient’s psychology, as well as the family’s, due to the aesthetic problems caused by it (1, 2, 3).
We present the case of a neonate with a giant congenital melanocytic nevus occupying an extensive area of the torso, accompanied by multiple satellite lesions in the limbs and the scalp. On ultrasoundand MRI examination the brain proved to be normal The neonate was asymptomatic. The importance of the proper evaluation and investigation is highlighted, aiming at the timely diagnosis for the detection of the early symptoms and/or of melanoma.
Key words: Congenital melanocytic nevus, neonate
F. Balomenou
T. Palianopoulos
A. Drougia
V. Giapros
NICU, University Hospital of Ioannina, Ioannina
I. Basoukas
G. Gaitanis
Dermatology Department, University Hospital of Ioannina, Ioannina
CMN: congenitalmelanocyticnevus
NCM: neurocutaneous-
GCMN: giantcongenitalmelanocyticnevus
Βιβλιογραφία
1. rarediseases.org /rare-diseases/giant-congenital-melanocytic-nevus/
2. Viana AC, Gontijo B., Bittencourt FV. Giant congenital melanocytic nevus. An Bras Dermatol. 2013 Nov-Dec; 88(6): 863-878
3. Viana AC,Goulart EM, Gontijo B., Bittencourt FV. A prospective study of patients with large congenital melanocytic nevi and the risk of melanoma. An Bras Dermatol. 2017 Mar-Apr; 92(2): 200-205
4. Al-Hadithy N., Al Nakib K., Mc Gurk S., Quaba A. Primary intracranial melanoma in a child with a giant congenital naevus and normal MRI. BMJ Case Rep. 2013; 2013: bcr2013009276
5. Scattolin MA, Lin J, Peruchi MM, Rocha AJ, Masruha MR, Vilanova LC. Neurocutaneousmelanosis: follow-up and literature reviw. J Neuroradiol. 2011 Dec; 38(5): 313-8
6. Yakut ZI, Bas AY, Turan A., Demirel N., Demirkan TH. Early Sonographic Diagnosis of NeurocutaneousMelanosis in a Newborn. Iran J Radiol. 2014Dec; 11(4): e 10107
7. Kinsler VA, Aylett SE, Coley SC, Chong WK, Atherton DJ. Central nervus system imaging and congenital melanocytic naevi. Arch Dis Child 2001; 84:152-155
8. Leech S., MRCP, Bell H. MRCP, Leonard N. MRCPath et al. Neonatal Giant Congenital Nevi With Proliferative Nodules. Arch Dermatol. 2004; 140(1) :83-88
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(Uniform Requirements for Manuscripts Submitted to Biomedical Journals),
International Committee of Medical Journal Editors/Uniform Requirements for Manuscripts Submitted to Biomedical Journals, (www.icmje.org και www.icmje.org/icmje. pdf).
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