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Objectives: Congenital heart defects (CHDs) are among the most frequent congenital defects, and they significantly burden the healthcare system due to their high mortality rate and high cost of care for survivors. We aimed to highlight the incidence of CHDs in a tertiary center in Western Romania. Methods: A retrospective study was carried out between 2018 and 2022 at the "Pius Brinzeu" Emergency County Hospital Timisoara. Relevant information about the mothers and the newborns were collected and statistically analyzed. Results: The incidence of CHDs from 2018 to 2022 in our center was 5.3%. Eleven types of malformations were diagnosed postnatally in 541 newborns, with 28.8% of cases having more than one type of CHD. The antenatal detection rate was 28%, with the highest rates for tetralogy of Fallot, hypoplastic left heart syndrome, or significant ventricular septal defects and the lowest for pulmonary stenosis. The lower antenatal detection rate was influenced mainly by incomplete or absent prenatal care. Conclusions: The incidence of CHDs is clearly dependent of a multifactorial approach, and the results highlight this. With an incidence almost 50% lower than reported within the literature and a low rate of prenatal detections, CHDs could be a more of a burden to endure regarding medical treatment. Improvements in patients' education, prenatal care, and screening programs could improve diagnosis, decrease mortality, and optimize postnatal care. [ABSTRACT FROM AUTHOR]

Introduction: Hyperthyroidismis a prevalent condition affecting global populations, with an overall prevalence of 1.2%. Our research aimed to establish a systematic diagnostic approach using multiparametric ultrasound (MPUS) to diagnose hyperthyroid diffuse thyroid disease (DTD). Methods: We conducted a retrospective study from June 2021 to June 2023 at a specialized endocrinology center in Timisoara, Romania, enrolling subjects presenting with clinical hyperthyroidism. Using the Mach 30 Aixplorer ultrasound equipment, evaluations were performed initially in Bmode US, followed by Color Doppler and Spectral Doppler measurements, and finally, 2D Shear wave elastography (SWE). Results: From the 218 patients analyzed, the diagnosis of DTD with hyperthyroidism was confirmed through biochemical assessment, subgrouping various pathologies such as subacute thyroiditis, Graves' disease, painless thyroiditis, Hashimoto's thyroiditis, iatrogenic, as well as healthy controls. In the first step, B-mode hypoechogenicity had an AUC of 0.951 for DTD detection. In the second step, the peak systolic velocity differentiated Graves' disease with a median of 42.4 cm/s and an AUC of 1. Lastly, the third step consisted of SWE evaluation, revealing a mean elasticity index in the SAT subgroup significantly higher from other subgroups (p<0.001) with an AUC of 1. Conclusion: Our study offers a step-by-step evaluation algorithm for DTD diagnosis, with a very good overall diagnostic performance (AUC of 0.946). [ABSTRACT FROM AUTHOR]

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This paper aims to assess the usefulness of shear-wave elastography (SWE) and strain elastography (SE) for identifying and monitoring thyroid gland changes in children diagnosed with chronic autoimmune thyroiditis (CAT). Our study included 77 children between the ages of six and eighteen. Of these, 45 were diagnosed with CAT, while 32 had no thyroid pathology. Following a clinical examination and laboratory tests, an ultrasound was carried out, and then a SE (using a Hitachi Preirus machine) and SWE (using an Aixplorer Mach 30, Supersonic imagine, France) were performed in the same session. The median thyroid elastic index (EI) in the CAT group was 13.8 (13.3–17) kPa compared to 10.1 (9.3–11.2) kPa in healthy children (p < 0.0001). We found a median strain ratio (SR) of 1.2 (1.2–1.3) for CAT compared to 0.7 (0.6–0.9) for healthy thyroid tissue (p < 0.0001). The optimal cut-off value for predicting the presence of CAT in children using SR was >1 (Se = 82.2%, Sp = 87.5%, PPV = 90.2%, and NPV = 77.8%, AUROC = 0.850), while using SWE, the optimal cut-off value for predicting the presence of CAT in children was >12 kPa (Se = 88.9%, Sp = 93.7%, PPV = 95.2%, and NPV = 85.5%, AUROC = 0.943). Both techniques are useful for measuring thyroid tissue elasticity, and their diagnostic accuracy and reliability are comparable. [ABSTRACT FROM AUTHOR]

Child obesity is a complex, multifactorial, chronic medical pathology. There is no consensus in treating child obesity, so prevention remains still an ideal approach. If prevention did not succeed, then nutritional intervention is needed. In the last years, there is evidence that nutrition in early infancy and childhood might be used as a preventive tool in the management of obesity. Some factors in early life are important for the risk of overweight and obesity later in childhood. Among the postnatal factors, breastfeeding and complementary feeding are of interest. Breastfeeding has been shown to reduce the risk of later obesity. A high protein intake during complementary feeding is associated with a higher risk of obesity while, a high fat intake during this period does not seem to be a risk factor for later obesity. On the contrary, in older children and adults, a high fat intake is associated with higher risk of obesity. Rapid weight gain early postnatal (0 - 6 months), seem to be a good indicator for the risk of obesity later in life. If prevention does not succeed then, dietary intervention would be the second tool in management. Some standard general recommendations and also some special dietary models (low/medium carbohydrate diet, energy restricted diet, low glycaemic index diet) can be used to treat overweight/obese children. Conclusion. Nutrition even since early childhood is essential to prevent later obesity; nutritional intervention should be adapted to age and need to keep in mind that the child is continuously growing. [ABSTRACT FROM AUTHOR]

Introduction: Polymyositis is an inflammatory muscle disease, with autoimmune character. Aim: To present the case of a 15 years adolescent with myopathy. Case report: A 15 years old male patient was admitted to the hospital complaining of severe muscle pain in the arms and legs. Clinical exam revealed: warm teguments, muscular hypertonia, limited flexion of the legs on the thighs, limited extension of the arms and rising of the arms over the head. Laboratory findings: CK = 603 U/L, LDH = 999 U/L, ESR = 30 mm/h; CRP = 46.2 mg%. The neurological exam found: secondary inflammatory myopathy. EMG: hyper-voltage potentials with short duration, increased pattern of recruitment, suggestive for a myopathy. Muscle biopsy revealed: local atrophy of muscle fibers, endomysium inflammatory lymphocytic infiltrate and perivascular infiltration. Myositis-specific antibodies (Anti-Mi-2, Anti Jo-1, Anti SRP, Anti Pl-7, Anti Pl-12, Anti EJ, Anti OJ) and myositis-associated antibodies (Anti Ku, Anti Pm-Scl 100, Anti Pm-Scl 75, Anti Ro-52) were all negative. The results of the investigations correlated with the clinical context leaded to the diagnostic of Primary idiopathic polymyositis. Pulse corticosteroid therapy with intravenous Methylprednisolone was initiated (1 g per day for 3 days), and then orally corticosteroid therapy with Prednisone (80 mg per day, with progressive decrease of the dose). The symptoms remitted after therapy, the muscular enzymes normalised but the inflammatory syndrome persists and so does the EMG myogenic route. Particularity of the case: male patient with negative specific antibodies and arthropathic onset. [ABSTRACT FROM AUTHOR]

Child obesity is a multifactorial disease. At present, prevention is the most effective approach. Aim: To determine the dynamic of overweight and obesity and the presence of some of the already known risk factors. Material and Methods: The retrospective study was performed in IInd Clinic of Pediatrics, Timisoara for a 3 year period. The study group included 174 children, 88 boys and 86 girls, with a mean age 11.87 +/- 3.33 years, evaluated for excessive weight. The first evaluation included complete personal and medical history, and complete physical exam including anthropometric indexes and specific biochemical tests. Results and discussions: Out of the study children 8.05% were overweight, 40.23% had mild and moderate obesity, and 51.72% had severe obesity. The majority (71.83%) of cases were from urban areas. Positive family history of obesity was seen in 31.03% (n = 54) of children. More than half of these children, (62.96%) were severely obese. A small percent (15.73%) were SGA or LGA. 74.84% were naturally born and only 25.16% by caesarean section. More than half of the obese children, (55.08%) were breastfed for one or two months or fed with formula or cow milk from the beginning. Conclusion: Positive family history for obesity is a strong predictor for child obesity. Mode of delivery, birth weight, breastfeeding are also involved in child obesity development but evaluated separately seem to play less important roles. [ABSTRACT FROM AUTHOR]

The pituitary lies within the sella turcica and has a very important role in the regulation of the neuro-endocrine functions through its hormones. Prolactinoma represents a benign tumor of the pituitary (adenoma) which excesively produces the hormon called prolactin. The authors present the case of a male adolescent 16 years old, evaluated in the pediatrics ambulatory for height deficit. On this ocassion increased levels of prolactin were revealed. Later on the patient was admitted in Clinic II Pediatrics to complete investigation for diagnosis. [ABSTRACT FROM AUTHOR]

Glanda hipofiză este situată la baza creierului, într-o formaţiune anatomică osoasă numită şaua turcească (sella turcica). Are un rol extrem de important în reglarea funcţiilor neuro-endocrine datorită hormonilor secretaţi. Prolactinomul reprezintă o tumoră benignă a glandei hipofize (adenom), ce produce în exces un hormon numit prolactina. Autorii prezintă cazul unui adolescent în vârstă de 16 ani, evaluat în ambulator pentru deficit staturo-ponderal, ocazie cu care s-au decelat valori crescute ale prolactinei serice. Ulterior, pacientul se internează în Clinica II Pediatrie pentru investigaţii suplimentare şi precizare de diagnostic. [ABSTRACT FROM AUTHOR]