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This article discusses the oral manifestations of primary pediatric vasculitis, specifically focusing on IgA vasculitis and Kawasaki disease. It emphasizes the importance of oral symptoms in early diagnosis and the need for healthcare professionals, including dentists, to examine and treat children with these symptoms. The article also explores the oral manifestations of Systemic Lupus Erythematosus (SLE) in children, highlighting the importance of early detection of oral ulcers for diagnosis and treatment. Additionally, it discusses other oral conditions associated with SLE and calls for further research on the dental implications of SLE in pediatric patients. Another article titled "Nutrition and Oral Health in Children" examines the relationship between nutrition and oral health in children, emphasizing the role of a balanced diet and proper nutrition in maintaining good oral health. It provides valuable insights for parents, caregivers, and healthcare professionals interested in understanding the impact of nutrition on children's oral health. [Extracted from the article]

The human intestinal microbiota is a highly intricate structure with a crucial role in promoting health and preventing disease. It consists of diverse microbial communities that inhabit the gut and contribute to essential functions such as food digestion, nutrient synthesis, and immune system development. The composition and function of the gut microbiota are influenced by a variety of factors, including diet, host genetics, and environmental features. In pediatric patients, the gut microbiota is particularly dynamic and vulnerable to disruption from endogenous and exogenous factors. Recent research has focused on understanding the interaction between the gut and kidneys. In individuals with chronic kidney disease, there is often a significant disturbance in the gut microbiota. This imbalance can be attributed to factors like increased levels of harmful toxins from the gut entering the bloodstream, inflammation, and oxidative stress. This review looks at what is known about the link between a child's gut–kidney axis, how dysbiosis, or an imbalance in the microbiome, affects chronic kidney disease, and what treatments, both pharmaceutical and non-pharmaceutical, are available for this condition. [ABSTRACT FROM AUTHOR]

Coexistenţa t(9;22) şi a inv(16) a fost descrisă într-un număr limitat de cazuri de LMC, LAM de novo sau LAM post chimioterapie. Raportăm un pacient cu LMC care a prezentat atât inversie de 16 cât şi cromozom Philadelphia şi care a evoluat spre criză blastică sub tratament cu Imatinib. Diagnosicul de laborator şi monitorizarea s-a realizat prin citometrie în flux, citogenetică convenţională şi tehnici de genetică moleculară. Inv(16), detectată prin cariotipare în clona Philadelphia pozitivă la momentul transformării blastice, a fost evaluată retrospective prin metoda real-time PCR, şi s-a dovedit a fi fost prezentă încă de la diagnostic. Biopsia de măduvă osoasă, efectuată în faza blastică a LMC, a confirmat prezenţa blaştilor aparţinând liniei mieloide, cu indicii de diferenţiere monocitoidă, frecvent asociată cu inv (16). De asemenea, cazul a asociat şi mutaţia F359V în domeniul kinazic al ABL, care determină rezistenţă intermediară la Imatinib şi Nilotinib, ceea ce a impus schimbarea terapiei cu Dasatinib. În cazul prezentat evoluţia a fost progresivă, urmată de deces ca urmare a lipsei de răspuns la inhibitorii de tirozin kinază, la 18 luni de la diagnosticare. Coexistenţa t(9; 22) şi inv(16) în LMC pare a fi asociată cu o evoluţie clinică agresivă şi rezistenţă la terapia cu inhibitori de tirozin kinază. Având în vedere numărul foarte mic de cazuri descrise în literatura de specialitate, deciziile terapeutice în cazul pacienţilor care prezintă aceste anomalii sunt încă dificile

Introducere. Pacienţii cu leucemie acuta limfoblastică (LAL) neonatală prezintă în mod frecvent, o tran- slocaţie particulară, t(4;ll)(q21;q23), care duce la fuziunea genei MLL (mixed lineage leukemia) de pe cromo- zomul 11 cu gena AF4 de pe cromozomul 4. Deşi în literatura de specialitate au fost descrise anterior cazuri de LAL neonatală caracterizate prin prezenţa unor produşi de fuziune MLL-AF4 cu variate puncte de ruptura, cazul prezentat în acest material este inedit, atât prin complexitatea fuzatului MLL-AF4 identificat, cât şi prin particu- larităţile sale clinico-biologice. Materiale şi metode. Intr-o probă de sânge periferic provenită de la un nou-năs- cut în vârstă de 21 de zile a fost testată, prin biologie moleculară, prezenţa genelor de fuziune: TEL-AML1, BCR-ABL(plQO). E2A-PBX1 si MLL-AF4. Fragmentul MLL-AF4 identificat, având o lungime neobişnuită, a fost purificat şi secvenţiat. Evaluarea imunofenotipică a blaştilor leucemici circulanţi s-a efectuat prin citometrie în flux, multiparametrică, utilizându-se un citometru FACSCanto-II (Becton-Dickinson). Rezultate. S-a identificat un transcript de fuziune MLL-AF4 cu o secvenţă particulară (fuziunea exonului 12 de pe gena MLL cu exonul 4 de pe gena AF4). Evaluarea imunofenotipică a evidenţiat, de asemenea, o evoluţie particulară: la diagnostic s-a des- cris o clonă malignă cu fenotip de precursor limfoid B, în timp ce la recădere s-a evidenţiat expansiunea predominantă a unei clone monocitoide. Prezenţa aceluiaşi transcript MLL-AF4(el2-e4) a fost evidenţiată şi la recădere, în absenţa oricăror altor fuzaţi caracteristici pentru lineajul mieloid. Concluzie. Considerăm că particularităţile punctelor de ruptură care au dus la generarea rearanjamentului MLL-AF4 în acest caz sunt inedite, nemaifiind menţionate anterior în literatura de specialitate. Detecţia sa timpurie are potenţial predictiv pentru switch-ul imunofenotipic şi implicaţii în optimizarea strategiilor terapeutice.

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Pediatric chronic hemodialysis has been significantly improved by the usage of long-life catheters. A frequent cause of catheter dysfunction is thrombosis in various forms. We present a case series of three pediatric patients with thrombosis of the long-life central venous catheters, illustrate the various evolutions of this complication, and, in consequence, the necessity of a multidisciplinary team approach in order to achieve the best permanent access pathway. [ABSTRACT FROM AUTHOR]

A variety of conditions can cause pleurisy in children. The most frequent is a results of infection, secondary to a pneumonia or a tuberculosis. In most of the cases the diagnostic is easy, by biochimical and bacteriological examination of the pleural fluid. We know from the literature that empyema is a sign of bacterial pleurisy, but in some cases there is dificult to obtaining the diagnosis of certainty. We present a case of pleural effusion whose unexpected diagnosis followed a long line of intermediate diagnoses. This all have been suggested by clinical evolution, but also by laboratory data. The final diagnosis resulted after the occurrence of laterocervical lymph mass and was confirmed by immunohistochemical studies on ganglion biopsy. [ABSTRACT FROM AUTHOR]

Acute lymphoblastic leukemia represents a heterogeneous group of hematological malignancies, defined by clonal proliferation of lymphoid cells. Immunophenotyping by flow cytometry and molecular analysis for the detection of genetic anomalies are clinical standard procedures for diagnosis, sub-classification and post-therapeutic evaluation. Samples from 105 patients diagnosed with acute lymphoblastic leukemia were immunophenotyped at diagnosis and were investigated by molecular analysis in order to identify the occurrence of four fusion genes: MLL-AF4, TEL-AML-1, BCR-ABL-p190, E2A-PBX-1. There were no associations found between the immunophenotype and the presence of any fusion genes evaluated. Both methods in combination remain a prerequisite for an improved subclassification of hematological malignancies, therapeutic decision, and evaluation of treatment response. [ABSTRACT FROM AUTHOR]

Tumorile sistemului nervos central (SNC) sunt cele mai frecvente tumori solide din patologia tumorală pediatrică şi reprezintă o provocare terapeutică pentru o echipă medicală multidisciplinară. Tumorile cerebrale pot fi diagnosticate la orice vârstă; semnele şi simptomele depind de vârsta pacientului, de sediul tumoral, precum şi de ritmul de creştere al tumorii. Clasificarea (Bailey şi Cushing, Kernohan, Organizația Mondială a Sănătății - OMS) şi prognosticul sunt dictate de histologia tumorală. Prezentul studiu îşi propune evidențierea unor factori de prognostic implicați în evoluția tumorilor SNC la copil. Lotul de studiu a inclus 99 de copii diagnosticați cu tumori SNC în perioada 1990-2008, 66 de băieți şi 33 de fete; 59,6% din mediul rural. Vârsta medie la debut a fost de 8 ani şi 5 luni, fără diferențe pe sexe. Durata debutului a variat de la 4 ore la 2 ani. Histologic, au fost 46 de astrocitoame, 23 de meduloblastoame, 17 ependimoame, 3 craniofaringioame, un caz de tumoră hipofizară şi 9 alte tipuri de tumori. Simptomatologia de debut a inclus hipertensiunea intracraniană (70 cazuri), tulburările neurologice (74 cazuri), tulburările vizuale (24 cazuri), convulsiile (7 cazuri), alte simptome (14 cazuri) şi coma în 2 cazuri. Intervențiile chirurgicale au fost de tipul: ablație totală (34 cazuri), subtotală (27 cazuri), parțială (19 cazuri); în 6 cazuri a fost efectuată doar biopsia tumorală, iar în 8 cazuri nu s-a intervenit chirurgical. Investigațiile biologice efectuate au arătat: VSH - valoarea medianei - 17 mm/h, Fg - 3,6150 g/L, LDH - 379,5 UI/L. În primii 3 ani de la diagnostic au decedat 50% dintre pacienți, cu o rată de supraviețuire repartizată astfel: 34 de cazuri mai puțin de 1 an, 19 cazuri între 1 şi 3 ani, 46 de cazuri peste 3 ani. În lotul studiat nu au fost descoperite diferențe semnificativ statistice între valorile VSH, Fg, LDH, vârstă la debut şi supraviețuire; doarsexul masculin şi tipul intervenției chirurgicale se corelează statistic cu supraviețuirea şi pot fi considerate de importanță prognostică. [ABSTRACT FROM AUTHOR]

Central nervous system (CNS) tumors are the first encountered solid tumor in pediatric oncology and represent an important therapeutic challenge for a multidisciplinar team. Brain tumors are diagnosed at any age; sign and symptoms are related to age, site and tumor growth. Histological features are important to classification (Bailey and Cushing, Kernohan, World Health Organisation) and prognosis. Aim of the present study was to find prognostic features of pediatric CNS tumors. We studied a group of 99 children diagnosed with CNS tumors between 1990 and 2008, 66 boys, 33 girls; 59.6% from rural areas. Median age at onset was 8 years and 5 months, without gender difference. Time of onset ranged from 4 hours to 2 years. There were 46 astrocytomas, 23 medulloblastomas, 17 ependymomas, 3 craniopharingiomas, 1 hipophiseal tumor and 9 other types of tumors. Onset symptoms included increased intracranial pressure (70 cases), neurological disorders (74 cases), visual disturbances (24 cases), seizures (7 cases), other symptoms (14 cases) and coma (2 cases). Surgical treatment was: total tumor resection (34 cases), subtotal resection (27 cases) and partial resection (19 cases); 6 cases underwent only tumoral biopsy, 8 cases did not undergo surgery. Median value of Erythrocite Sedimentation Rate (ESR) at onset - 17.00 mm/h. Median values of Fibrinogen (FG) at onset - 3.6150 g/L. Median value of Lacticdehidrogenosis (LDH) - 379.5 IU/L. Overall survival was variable, from less than 1 year in 34 cases, between 1 and 3 years in 19 cases and over 3 years in 46 cases. 50% of cases were dead in the first 3 years after diagnose. Analysis of survival according to ESR, FG and LDH showed no statistically significant differencies between them but between type of surgery and death is a direct relationship. Survival analysis for the event death according to age at onset revealed no significant differences between categories of patients ordered by age. Type of surgery seems to be the most important feature involved in prognosis in CNS tumors of children. [ABSTRACT FROM AUTHOR]

The management of patients with steroid-resistant nephrotic syndrome is difficult. We report our experience on treatment with Mycophenolate mofetil versus Cyclophosphamide, in a retrospective analysis of 54 cases of idiopathic steroid-resistant nephrotic syndrome with different histological aspects. The complete and sustained remission rate was 50% for Mycophenolate, which confirm the efficacy of treatment, higher than with Cyclophosphamide (39.53%). [ABSTRACT FROM AUTHOR]

Managementul pacienţilor cu sindrom nefrotic corticorezistent (SNCR) este dificil. Vom prezenta experienţa noastra În tratamentul cu Mycofenolat de mofetil versus Ciclofosfamida, Într-o analiza retrospectiva a 54 de cazuri cu sindrom nefrotic corticoresistent idiopatic cu aspecte histologice diferite. Rata remisiunii complete şi susţinute a fost de 50% pentru Mycofenolat, ceea ce confirms eficienţa tratamentului, aceasta rata fiind mai mare decât În tratamentul cu Ciclofosfamida (39,53%). [ABSTRACT FROM AUTHOR]

Unlabelled: Acute leukemia is the most common malignancy in children, being mostly produced by such chromosomal abnormalities as translocations or inversions causing gene fusion. Different clinical studies showed that translocations identified in ALL (acute lymphoblastic leukemia) and AML (acute myeloblastic leukemia) may be used to classify patients into risk groups., Aim: To detect three fusion genes that have been proven very important in patient classification: t(9:22)p190, t(4:11) and t(12:21)., Material and Method: We conducted a prospective study on 30 patients with acute leukemia diagnosed in the interval September 2009 - September 2010 at the Iasi Hemato-Oncology Unit of Saint Mary Hospital for Children., Results: We found t(9:22)p190 in two patients, t(4:11) in two patients and t(12:21) in one patient. From the total of 30 patients, 7 were considered at high-risk, 3 were diagnosed with AML, and 20 were considered at standard-risk., Conclusions: Day 33 can still be considered the reference time in the evaluation of treatment response; patients with BCR-ABL seem to have a worse prognosis than those who do not have this translocation. The detection of fusion genes is very important in patient classification.

Langerhans cell histiocytosis is a group of idiopathic disorders characterized by the proliferation of cells of the mononuclear phagocyte system and the dendritic cell system. From the clinical point of view there are 3 forms of histiocytosis encountered in child pathology: acute, disseminated called Abt-Letterer-Siwe (it usually affects children under 2 years of age), eosinophilic granuloma and the intermediate clinical form called Hand-Schuller-Christian disease. We present the case of a premature born child that had, even from the day she was born, a rash disseminated on the entire surface of the body associated with enlarged lymph nodes, hepatosplenomegaly and thrombocytopenia. The diagnosis of Langerhans cell Histiocytosis is difficult to establish and this case is an example that confirms it. Therefore, we present the difficulties in diagnosing this case and its particular evolution.