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Ileana Ioniuc

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

PARTICULARITATI IN RINOSINUZITA CRONICA LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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PARTICULARITATI IN RINOSINUZITA CRONICA LA COPIL

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REZUMAT

Rinosinuzita cronică (RSC), este o patologie rară în pediatrie comparativ cu adultul. Manifestările clinice sunt în relaţie, pe de o parte, cu particularităţile anatomice, iar pe de altă parte, cu cele de răspuns imun corelate cu vârsta copilului. Alergia constituie cauza principală în 50% dintre rinitele copilului, 40% dintre acestea debutând precoce până la vârsta de 6 ani. Expresia clinică a rinosinuzitei alergice la copil poate fi uneori însoţită de manifestări ale comorbidităţilor alergice asociate sau de complicaţii de vecinătate. Alterarea clearance-ului mucociliar poate fi însă indus şi de alte situaţii patologice mai rare care produc modificarea proprietăţilor reologice ale mucusului, ca în mucoviscidoză (FC). Prin heterogenitatea de expresie clinică în relaţie pe de o parte cu particularităţile de răspuns imunogenetic şi anatomice raportate la vârsta copilului şi pe de altă parte cu diversitatea factorilor etiologici inductori (de la foarte frecvenţi, precum alergia, la foarte puţin frecvenţi, FC), RSC impune un diagnostic corect, precoce şi un tratament adecvat prin colaborarea în echipă multidisciplinară.

Cuvinte cheie: rinosinuzită, copil, fibroza chistică, alergie

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PARTICULARITIES IN THE CHILD CHRONIC RHINOSINUSITIS

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 4, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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PARTICULARITIES IN THE CHILD CHRONIC RHINOSINUSITIS

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ABSTRACT

Chronic rhinosinusitis is a rare pathology in pediatric pathology versus adult patients. Clinical manifestations are related, on the one hand, with the anatomical particularities and, on the other hand, with the immune response correlated with the age of the child. Allergy is the main cause in 50% of child rhinitis, 40% of them debuting early until the age of 6 years. The clinical expression of allergic rhinosinusitis in children can sometimes be accompanied by comorbidity manifestations or complications. Impaired mucociliary clearance can be induced by other rare pathological situations that produce mucus rheology modification, as in cystic fibrosis (CF). Through, the clinical heterogenicity of expression is in relation, on the one hand, with immunogenic response and anatomical particularities relative to age of the child, and secondly with the diversity of inducing factors (from very frequent like allergy to the least frequent, CF). It requires a correct diagnosis, early and appropriate treatment by a multidisciplinary team collaboration.

Keywords: rhinosinusitis, child, cystic fibrosis, allergy

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ATOPIA, FACTOR DE RISC IN APARITIA OTITEI SEROASE LA COPIL

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ATOPIA, FACTOR DE RISC IN APARITIA OTITEI SEROASE LA COPIL

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ABSTRACT

Otita medie seroasă cronică, cauză majoră a hipoacuziei în perioada copilăriei, este frecvent asociată cu sensibilizarea alergică. Prevalenţa în continuă creştere a atopiei la această vârstă implică o abordare multidisciplinară a copiilor cu adenoidite, otite recurente şi disfuncţii tubare, în vederea unui management patogenic complex.
Obiectivul studiului a constat în determinarea asocierii otitelor medii cu bolile alergice, şi implicaţiile acestei asocieri în tratamentul şi evoluţia pacienţilor.
Material şi metodă. S-a realizat un studiu retrospectiv care a inclus 92 de copii, cu vârste cuprinse între 6 luni şi 6 ani internaţi în Clinica II Pediatrie, Spitalul Clinic de Copii „Sf. Maria“, Iaşi, cu diagnosticul de otită medie, pe o perioadă de 1 an (ianuarie 2015 – ianuarie 2016).
Rezultate. Majoritatea cazurilor au fost otite supurate (61 de pacienţi), 31 de cazuri au fost otite seroase, dintre care 23 au fost recurente. Asocierea cu bolile alergice a fost mai frecventă la copiii cu otită seroasă (26/31 cazuri). 4 pacienţi cu otită supurată au prezentat reacţii adverse la antibiotice, cu implicaţii majore în evoluţia cazurilor. Asocierea cu refluxul gastroesofagian a fost relativ asemănătoare între cele 2 loturi (11/61 de cazuri şi respectiv 10/31 de cazuri), la 10 pacienţi atopici, obiectivându-se alergia la proteinele laptelui de vacă.
În concluzie, copiii cu otite medii, în special cei cu otite medii seroase recurente ar trebui investigaţi pentru determinarea coexistenţei atopiei şi a refluxului gastroesofagian, eventual cu dozarea markerilor de inflamaţie alergică sau a pepsinei în exsudatul otic, în vederea unui management terapeutic ţintit.

Keywords: otită seroasă, alergie, copii

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ATOPY, RISK FACTOR FOR OTITIS MEDIA WITH EFFUSION

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Revista Romana de PEDIATRIE | Volumul LXV, Nr. 2, An 2016
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ATOPY, RISK FACTOR FOR OTITIS MEDIA WITH EFFUSION

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ABSTRACT

Chronic otitis, one of the major causes of pediatric hypoacusia is frequent associated with some allergic diseases. The continuous rice of atopic diseases prevalence in childhood, involves a multidisciplinary approach of Eustachian tube dysfunction, adenoid inflammation or recurrent otitis, for a complex pathogenic management.
The objective of this study was to determinate the association between otitis media and the allergic diseases with the implication in the treatment and evolution of this patients.
Methods. Retrospective study on 92 children, between 6 month and 6 years, admitted in II Pediatric Clinic, Clinical Hospital of Children “Sf. Maria” Iasi with diagnosis of acute otitis media, for a period of 1 year.
Results. Majority of cases (61patients) have been suppurate otitis, 31 cases have been otitis media with effusion out of which 23 have been recurrent. Association with allergic diseases has been more frequent in children with serous otitis media (26/31 cases). 4 cases with suppurate otitis media have developed adverse reaction to antibiotics with major implication in the cases evolution. Association with gastroesophageal reflux was relatively similar between cases with serous otitis and the suppurate ones (10/31 cases and 11/61 cases). From the atopic patients with gastroesophageal reflux, 10 presented cow’s milk protein allergy.
In conclusion, the children with otitis media, especially those with recurrent none suppurate form should be investigated for atopy and, eventually, for gastroesophageal reflux, possibly with determination of the allergic markers or of pepsin in the otic exudates, in order to a targeted therapeutic management.

Keywords: otitis, effusion, allergy, children

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Scleroderma in young children

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Scleroderma in young children

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ABSTRACT

Chronic disease of unknown etiology, scleroderma represents a disease that occurs rarely in young children, with an estimated frequency of less than 1% up to age 5. Evolution of scleroderma is variable, unpredictable and the delineation of clinical forms in children is difficult. Some patients may experience periods of calm for many years, others have a progressive worsening, without remission and death. Our case is characterized by the onset at a young age, bringing together major and minor criteria for systemic scleroderma.

Key words: systemic scleroderma, young children

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SCLERODERMIA LA COPILUL MIC

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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SCLERODERMIA LA COPILUL MIC

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REZUMAT

Boală cronică de etiologie necunoscută, sclerodermia este o boală care apare rar la copilul mic, estimându-se o frecvenţă de sub 1% până la vârsta de 5 ani. Evoluţia cazurilor de sclerodermie este variabilă, imprevizibilă, delimitarea formelor clinice fiind dificilă la copil. Unii bolnavi pot prezenta perioade de acalmie mai mulţi ani, alţii au o evoluţie progresivă spre agravare (fără remisiuni) şi deces. Cazul prezentat se particularizează prin debutul sclerodermiei la vârstă mică, bolnavul întrunind, la 1 an si 3 luni, criterii majore şi minore de sclerodermie sistemică.

Cuvinte cheie: sclerodermie sistemică, copil mic

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Juvenile idiopathic arthritis – risk factors and clinical forms

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Juvenile idiopathic arthritis – risk factors and clinical forms

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ABSTRACT

The aim of this article is to determine the JIA’s risk factors and the prevalence of clinical forms, poiting out the difficulties of situating them at onset as well as in evolution taking into consideration a significant number of patients (169 cases). The outlined clinical forms (in order of frequency) were: oligoarthritis (44,17%), RFnegative polyarthritis (33.13%), enthesitis (11.24%), systemic arthritis (5.91%), RF-positive polyarthritis (2, 95%) and psoriatic arthritis (2.36%), with the percentage values close to those of other studies, except the RF-negative polyarthritis subtype in which the frequency is higher. Individualized analysis of cases revealed real time from onset of disease to diagnosis and risk factors for JIA (in order of frequency): traumatic (9,46%), positive family history (5,32%) and infections (2,35%). Also, it emphasized the possibility of transforming a clinical form to another even under adequate treatment.

Key words: juvenile idiopathic arthritis, risk factors, clinical forms

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ARTRITA JUVENILA IDIOPATICA – FACTORI DE RISC SI FORME CLINICE. STUDIU CAZUISTIC

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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ARTRITA JUVENILA IDIOPATICA – FACTORI DE RISC SI FORME CLINICE. STUDIU CAZUISTIC

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REZUMAT

Obiectivul este de a stabili factorii de risc şi prevalenţa formelor clinice de AJI cu evidenţierea dificultăţilor de încadrare la debut şi în evoluţie luând în studiu un lot semnificativ de bolnavi (169 cazuri). Formele clinice conturate (în ordinea frecvenţei) au fost: oligoarticulară (44,17%), poliarticulară cu FR negativ (33,13), entezită (11,24%), sistemică (5,91%), poliarticulară cu FR pozitiv (2,95%) şi psoriazică (2,36%). Analiza individualizată a cazuisticii a scos în evidenţă durata de la debutul real al bolii până la diagnostic, cât şi factorii de risc pentru AJI (în ordinea frecvenţei): traumatici (9,46%), antecedente familiale pozitive (5,32%) şi infecţioşi (2,36%). De asemenea, a fost evidenţiată posibilitatea transformării unei forme clinice în alta chiar sub tratament adecvat.

Cuvinte cheie: artrită juvenilă idiopatică, factori de risc, forme clinice

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Risk factors for asthma in children (6-18 years)

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Risk factors for asthma in children (6-18 years)

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ABSTRACT

Asthma is one of the most common diseases in children and an important cause of morbidity and mortality, with recent increased prevalence. Asthma diagnosis in children is often underestimated in early childhood. The aim of present study is to anamnestically assess using clinical and specific paraclinic exploration the incidence of the risk factors highly suggestive of asthma in children (6-18 years) and the correlation with disease severity. The questionnaires used in this study included relevant information to known risk factors for asthma during pre and postnatal period, preadolescence and adolescence stage. The principal risk factors for asthma identified in descending order of frequency were: personal atopy, recurrent wheezing, male gender, urban environment, indoor air allergens exposure (house dust, domestic animals, house mold) allergic sensitization to indoor allergens (house-dust mites), infant artificial feeding, family atopy, exposure to second hand tobacco smoke. Allergic polisensitization and tobacco smoke exposure are associated with severe asthma. The majority of cases were affected by asthma-related comorbid conditions and allergic rhinitis was the most frequent comorbidity.

Key words: asthma, child, risk factors, atopy

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FACTORI DE RISC PENTRU ASTMUL BRONSIC LA COPIL (6-18 ANI)

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 4, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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FACTORI DE RISC PENTRU ASTMUL BRONSIC LA COPIL (6-18 ANI)

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REZUMAT

Astmul bronşic este considerat una dintre din cele mai comune boli cronice ale copilului şi reprezintă o cauză importantă de morbiditate şi mortalitate, cu prevalenţă în creştere, conform estimărilor recente. La acest aspect contribuie subevaluarea diagnosticului la vârstă mică. Studiul îşi propune evaluarea anamnestică şi prin explorări clinico-paraclinice a incidenţei factorilor de risc sugestivi pentru suspiciunea de diagnostic de astm bronşic la copil, la vârsta de 6-18 ani, precum şi corelaţiile acestora cu gradul de severitate a bolii. Studiul a utililizat chestionare ce au inclus informaţii relevante pentru factorii de risc cunoscuţi ante şi postnatal precum şi cei asociaţi etapelor de viaţă preadolescent şi adolescent. Principalii factori de risc pentru astmul bronşic identificaţi în studiu (în ordinea frecvenţei) au fost: prezenţa atopiei personale, istoric de wheezing recurent, sexul masculin, mediul urban, expunerea la aeroalergeni de interior (praf, păr de animale, mucegai), sensibilizarea alergică la aeroalergeni (în special la acarieni), alimentaţia artificială, prezenţa atopiei familiale, fumatul pasiv. Polisensibilizarea alergică şi expunerea la fumul de ţigară se asociază cu forme mai severe de astm. Comorbidităţi alergice au fost prezente în majoritatea cazurilor, cea mai frecventă fiind rinita alergică (78%).

Cuvinte cheie: astm bronşic, copil, factori de risc, atopie

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