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This paper delineates several aspects of cystic fibrosis-related diabetes (CFRD)—a common complication of cystic fibrosis (CF). CFRD exhibits a predilection for older individuals with CF, yet it also extends its influence on children and adolescents. Scientific insights postulate a potential link between CFRD and the aberrant mucus production within the pancreas, thereby culminating in pancreatic insufficiency. This, in turn, perturbs the synthesis of insulin, a pivotal endocrine hormone responsible for the regulation of glycemic levels. Standardized protocols advocate for the systematic screening of CFRD among all individuals with CF, commencing at the age of 10 years using the oral glucose tolerance test (OGTT). Therapeutic modalities encompass insulin therapy, dietary adjustments, and the vigilant monitoring of glycemic parameters. The overarching objective is to maintain blood glucose levels within a targeted range to mitigate the advent of diabetic complications. Untreated or sub-optimally managed CFRD can precipitate a spectrum of deleterious health ramifications, encompassing cardiovascular afflictions, neuropathy, renal dysfunction, and ocular complications. [ABSTRACT FROM AUTHOR]

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Lyell syndrome – or toxic epidermal necrolysis – is a severe mucocutaneous reaction caused by the administration of a drug, and is characterized by extended lesions and systemic impairment. Cytokinic storm leads to multiorgan impairment and to metabolic disturbancies, which sometimes can determine the prognosis. There is no specific treatment and the evolution can be unpredictable. The authors present the case of a young girl with Lyell syndrome after the administration of neurologic medication. [ABSTRACT FROM AUTHOR]

Specific immunotherapy (SIT), or allergen vaccination, is a therapeutic option used by allergy physicians to reduce the clinical reactivity of allergic patients. It consists in gradual administration of increasing doses and concentrations of allergens involved in triggering allergic symptoms of patients. It is the only treatment that addresses directly to the causes of allergic hypersensitivity that underlies respiratory allergy such as rhinitis and allergic asthma. Unlike drugs, that mask or suppress allergic reactions, SIT acts by resetting the immune system in order to prevent these reactions (also known as desensitization). SIT represents the repeated administration of progressively increasing amounts of purified allergenic extract to sensitized individuals in order to induce immune tolerance. It is therefore the only etiological therapeutic option, acting at the immune level. Many controversies remain about the real effects of immunotherapy on individual immune status, and further studies are needed. Also, important in quantifying the therapeutic response would be finding specific predictive biomarkers of the immune response. [ABSTRACT FROM AUTHOR]

Viral C hepatitis affects 3% of the globe population and associates multiple immunological abnormalities, such as autoimmune hepatitis, autoimmune thyroiditis, and disorders of humoral immunity, which may increase during antiviral treatment. That's why we considered it necessary to evaluate the immunological manifestations in patients with viral hepatitis C, by performing a retrospective and prospective study, between 2009 and 2017, of 62 children with viral hepatitis C, admitted in Clinic II Pediatrics, "St. Mary" Hospital, Iaşi. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic hepatitis is a common cause of complications such as hepatic cirrhosis and hepatocellular carcinoma, even in the context of childhood infection. Concomitantly with hepatic involvement, viral infection can also be associated with a wide range of extrahepatic manifestations, the cause of which is mainly the formation of circulating immune complexes and storage in tissues and organs. In children, these extrahepatic manifestations are of a polymorphic nature, are sometimes severe and may influence the patient's long-term prognosis. The authors present the case of a teenager with two concomitant diseases with immune pathogenesis: chronic B hepatitis and psoriasis, discussing the complex interrelation between them. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are an important link in analgesic and anti-inflammatory therapy, both in adults and children. The classic mechanisms of action are recently explained by implications of the endocannabinoid system as part of their analgesic effect, and recent studies with R-profens suggest that this may be accomplished within the known mechanism of action of these compounds on COX. The involvement of the endocannabinoid system can lead the way for new drugs that target pain, without having undesirable gastrointestinal and cardiovascular side effects. There are studies that allow the oral use of topical anti-inflammatory with full efficiency and safety. [ABSTRACT FROM AUTHOR]

There are debates regarding actual infant and child immunization frame, both sides disputing the fundamental right of health. New and old, those diseases which are preventable through immunization have written history pages. Public voices have been heavily influenced by mass-media, and this attitude reflected in doubting vaccination. Actual trends for immunization in order to prevent rather than to treat is still under scientific debate. Vaccination coverage decreased significantly in Romania and in other countries. In this article, we try to list the most frequently invoked justifications that support the antivaccination attitude and to bring evidence from literature that many of these “arguments” are inaccurate. Old or new “myths” can be replaced with scientific pro-vaccine arguments. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cystic fibrosis (CF) is the most common potentially lethal genetic disease in the Caucasian population. The absence or decreased functionality of CFTR chloride transport channel results in impairment of water transport along cell membranes. The molecular mechanisms of the disease are currently being deciphered and their knowledge involves new therapeutic perspectives aimed at improving chloride channel dysfunction. [ABSTRACT FROM AUTHOR]

Background. Cirhogenetic chronic evolution of these patients is related to the etiology, co-morbidities, the type of virus, the addition of metabolic diseases. Fibrosis markers of biological and clinical aspects must be permanently monitored. Materials and method. In a retrospective study we followed 40 patients diagnosed with cirrhosis, in the IInd Pediatric Clinic of the „Sf. Maria“ Emergency Hospital for Children in Iasi, between 2004-2014, out of 239 cases chronically infected recorded in this period of time. Results. The analysis of patients with extrahepatic manifestations showed no statistically signifi cant differences, although the lack of seroconversion is more frequent in patients with extrahepatic manifestations versus those without (31.42% vs. 22.18%). The prospective study conducted in the pediatric population that was followed demonstrated that the risk of liver cirrhosis is by 3.03 times higher in male patients. The average age was 12.88 years, most children were diagnosed with liver cirrhosis after 10 years of age. The etiology predominant predisposing to development was HBV hepatitis, unlike hepatitis metabolic type, which has a milder trend. Conclusion. Complications detected included portal hypertension, ascites, pruritus, hepatic encephalopathy. In terms of frequency, itching had the largest share, followed by hepatic encephalopathy. [ABSTRACT FROM AUTHOR]

Worldwide, rotavirus are the leading cause of acute gastroenteritis (GEA) and is the most common cause of severe diarrhea in children under the age of 5 years. The immunity that the body develops after digestive infection with various causes is specific, of varying duration, similar to vaccine immunization in some cases, even being superior. [ABSTRACT FROM AUTHOR]

The diagnostic and treatment of autoimmune diseases which also involve a chronic HVC became a very important concern for specialists, taking into consideration the grim prognosis of the patients. Though the purpose of the antiviral therapy is targeted on primary liver disease, there are enough reasons regarding the efficiency and safety of using these therapies in patients with associated extra-hepatic manifestations. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Atopic dermatitis is a chronic skin inflammatory disease, with corrugated evolution especially in the first year of life, with different clinical aspects locations, depending on the age and stage of disease evolution. The etiopathogeny is incompletely elucidated. It implies the existence of an interconnection between immunological factors (IgE - mediated immune hyperreactivity involving Th2 lymphocytes), genetic (mutation of the filaggrin), environmental factors (allergens, infectious agents, physical, emotional stress), hereditary predisposition and pharmacological factors. The impact on quality of life is strong for the patient and for his familly. In recent years there has been an increase in the number of cases diagnosed. [ABSTRACT FROM AUTHOR]

Copyright of Pediatru.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducere. Boala fi catului gras non-alcoolic (NAFLD), cea mai frecventă cauză a bolii hepatice cronice la copii, cuprinde un spectru de afecţiuni variind de la steatoză simplă până la steatohepatită (NASH). Acidul ursodeoxicolic (UDCA) a fost utilizat la pacienţi adulţi cu NASH, demonstrându-şi efi cacitatea în doze crescute. Scop. De a evalua efectul tratamentului cu doze crescute de UDCA asupra parametrilor funcţiei hepatice la copii cu NASH. Metode. Lotul de studiu a fost constituit din 18 copii cu NASH cu vârste cuprinse între 2,5 şi 17 ani. NASH a fost operaţional defi nit ca fi catul difuz hiperechogenic la ecografi e cu valori persistent crescute (> 35 UI/l) ale alanin aminotransferazei (ALAT) sau aspartat aminotransferazei (AST), după excluderea cauzelor virale, drog sau alcool induse, colestatice sau genetice ale bolii hepatice. Pacienţii au fost trataţi cu acid ursodeoxicolic (20 mg/kg/zi), timp de şase luni. Rezultate. Tratamentul cu UDCA a determinat scăderea semnifi cativă a valorilor transaminazelor hepatice. Nivelurile ALT au variat între 68,5 (50-166) iniţial vs 47 (29-104) după şase luni, p < 0,001, AST între 43 (29-101) vs 34 (17-75), p < 0,001, şi GGT între 41,5 (11-150) vs. 22 (8-55). La sfârşitul tratamentului, niveluri ALT s-au normalizat la 4 dintre pacienţi. De asemenea, concentraţiile de colesterol au fost semnifi cativ reduse după tratament. Concluzii. Tratamentul cu doze crescute de acid ursodeoxicolic imbunătăţeşte parametrii funcţiei hepatice la copii cu NASH. [ABSTRACT FROM AUTHOR]

Introduction. Nonalcoholic fatty liver disease (NAFLD), the most common cause of chronic liver disease in children, encompasses a range of disease from simple steatosis to steatohepatitis (NASH). Ursodeoxycholic acid (UDCA) has been used in adult pacients with NASH, demonstrating its efficacy in high doses. Purpose. The aim of our study was to assess the effect of high-dose ursodeoxycholic acid therapy on liver functions in children with NASH. Methods. We prospectively studied 18 children with NASH aged 2.5 to 17 years. NASH was operationally defi ned as diffusely hyperechogenic liver at ultrasonography with persistently elevated (> 35 UI/l) alanine aminotransferase (ALT) or aspartate aminotransferaze (AST) after exclusion of viral, alcohol-induced, druginduced, cholestatic and genetic causes of liver disease. Patients were treated with ursodeoxycolic acid (20 mg/ kg per day) for six month. Results. Treatment with UDCA signifi cantly decreased hepatic transaminases. ALT levels ranged from 68.5 (50-166) at baseline vs. 47 (29-104) after six month, p <0.001, AST from 43 (29-101) 34 (17-75), p < 0.001, and GGT between 41.5 (11-150) vs. 22 (8-55). At the end of treatment, ALT levels normalized in 4 patients. Moreover, cholesterol levels were signifi cantly reduced after treatment. Conclusions. Treatment with high-dose ursodeoxycholic acid improves liver function parameters in children with NASH. [ABSTRACT FROM AUTHOR]

Atât obezitatea, cât şi astmul bronşic reprezintă boli puternic impactante în morbiditatea pediatrică a căror incidență înregistrează un trend ascendent în pofida eforturilor terapeutice actuale. Studiul îşi propune aprecierea interrelației dintre severitatea astmului bronşic şi obezitate precum şi impactul acesteia asupra incidenței şi gradului de severitate a exacerbărilor astmatice reflectate în calitatea vieții bolnavilor. Concluzii: Dereglările nutriționale complexe din cadrul obezității antrenează mecanisme patogenice interferente cu cele din astmul bronşic, agravând evoluția acestuia reflectată în modificarea calității vieții bolnavilor. [ABSTRACT FROM AUTHOR]

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by auto antibodies directed against self-antigens, immune complex formation and immune deregulations and may affect joints, skin, kidneys, heart, lungs, nervous system, and immune system. The onset can be variable and the symptoms can occur for many years. Parotitis as the initial manifestation of systemic lupus erythematosus (SLE) is a rare condition and can be associated with Sjogren's syndrome. In this article we present the case of a young patient who was diagnosed with Sjogren's syndrome retrospectively, after she met the criteria for SLE.

Unlabelled: Chronic hepatitis C is still an important health problem in children. Adequate management of those patients should be focused on two directions: disappearance or reduction of the viral load (conventional antiviral therapy) and treatment of autoimmune manifestations (corticoids, plasmapheresis, cytotoxic agents)., Aim: To associate extrahepatic manifestations with other disorders and to evaluate the evolution under specific (antiviral) and non-specific therapy., Materials and Methods: 43 children diagnosed with chronic hepatitis C and followed in the 2nd Pediatric Clinic Iaşi between January 2005 and June 2010., Results and Discussions: most children were diagnosed accidentally or for etiological investigations for elevated liver enzymes. Extrahepatic manifestations were found in 41.86% of patients, most of them with articular, skin and hematologic disorders, but also depression (2 cases) in those receiving interferon., Conclusions: In children, extrahepatic manifestations in chronic hepatitis C infection are more rare than in adults, especially with articular involvement. In certain cases, interferon therapy can trigger those manifestations with an immune mechanism. It is essential to evaluate the autoimmunity markers before proceeding with antiviral therapy.

Unlabelled: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are the frequent causes of acute and chronic hepatitis worldwide and the leading causes for hepatic cirrhosis and liver cancer. There is a distinct geographical variation in VHB and VHC incidence in adult and child., Aim: To assess the evolution trend of VHB and VHC incidence in child, in Romania and Iasi County, during the last two decades., Material and Methods: Data were obtained using information from the Reporting National System for acute viral hepatitis A, B, and C, from various geographical areas of Romania. Some systematical errors of information were identified, without significant influence of results and conclusions., Results: Results highlighted an incidence peak of VHB in Romania, in 1989, and in Iaşi county, in 1991 (43.1, respectively 41.2 per thousand inhabitants). The VHB incidence trend decreased after the implementation of vaccination programme, especially in children < 4 years old., Conclusions: The study remarked the necessity of viral hepatitis surveillance programme continuity in Romania and the importance of prevention measures including, for VHB, an optimal vaccination.

Unlabelled: The evolution of chronic viral and non-viral hepatitis in children, and the response to therapy influence the quality of life and the outcome of these patients and tehir family., Material and Method: This study analyzes the quality of life in children with chronic liver disease, using the records of 45 patients hospitalised in the Hepatology Department of "Sf. Maria" Hospital of Children in Iaşi. Data were customised using Kindle questionnaire, measuring the scores for quality of life in children and adolescents with chronic disease. Patients with chronic viral and autoimmune hepatitis hospitalised in the clinic were interrogated during three months (May-July 2008). All ethical aspects of clinical research were aproved and no child was harmed during the study. The questionnaire for children with chronic viral hepatitis, mostly with B virus, had a good aplicability, being simple and easy to respond., Results: The results showed a positive perception of the disease, probably because of the young age (under 17) and the fact that the liver disfunction was at low rates. The study of quality of life in children with chronic disease can be an efficient method for treatment efficiency evaluation.