The diagnostic value of magnetic resonance imaging in differentiating benign and malignant pediatric ovarian tumors

Background The diagnostic workup of ovarian tumors in children and adolescents is challenging because preserving fertility, in addition to oncological safety, is of particular importance in this population. Therefore, a thorough preoperative assessment of ovarian tumors is required. Objective To investigate the diagnostic value of MR imaging in differentiating benign from malignant ovarian tumors in children and adolescents. Materials and methods We conducted a retrospective study of all children and adolescents age <18 years who underwent MR imaging of ovarian tumors during 2014–2019 at a pediatric specialty center. Two radiologists reviewed all MR imaging. We used pathology reports to define the histological diagnosis. Results We included 30 girls who underwent MR imaging for an ovarian tumor. Signs indicative for malignancy were tumors with a diameter ≥8 cm, with areas of contrast enhancement, irregular margins, extracapsular tumor growth, and ascites. All benign and malignant ovarian tumors were correctly identified by the radiologists. Conclusion The diagnostic utility of MR imaging in classifying ovarian tumors in children and adolescents as benign or malignant is promising and might aid in defining the indication for ovarian-sparing versus non-ovarian-sparing surgery. We recommend evaluating these tumors with MR imaging prior to deciding on surgical treatment.

Mortality in Epilepsy: Referral to a Specialty Center Makes a Difference

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Perceptions of Pregnancy and Lactation from the Pregnancy and Lactation Autoimmune Network Registry

Objective.The Pregnancy and Lactation Autoimmune Network (PLAN) registry was established to evaluate the concerns of women with autoimmune or inflammatory rheumatic diseases (AIRD) pertaining to pregnancy and lactation.Methods.The registry was started as a survey of patients with AIRD at a single rheumatology specialty center in November 2016 and included questions regarding fertility, pregnancy, miscarriages, and lactation before and after diagnosis.Results.The study included 154 subjects from the PLAN registry. More than half (52%) of respondents indicated that their diagnosis negatively changed their views on pregnancy and nearly a third (30%) decided not to have children after AIRD diagnosis. Most (66%) women were concerned that medication use during the childbearing process would affect the baby. One-third (34%) indicated their views on breastfeeding negatively changed as a result of their disease diagnosis. The rates and duration of breastfeeding did not differ significantly for babies born before or after the mothers’ diagnosis (p = 0.50 and p = 0.21, respectively). Eighteen women in our study avoided breastfeeding or stopped breastfeeding earlier than planned to start a medication (including etanercept, adalimumab, hydroxychloroquine, and certolizumab) they believed to be contraindicated during lactation. The PLAN registry included 19 women who breastfed 22 babies while being exposed to a disease-modifying antirheumatic drug or biologic. None of these 19 women reported a delay in their children’s developmental milestones or higher infection rates.Conclusion.This study highlights an unmet need in patients with AIRD of childbearing potential for data and education regarding pregnancy and lactation.

LA EDUCACIÓN FAMILIAR EN EL TRATAMIENTO DE CASOS DE ADICCIONES AL ALCOHOL Y OTRAS DROGAS

En el presente artículo se pretende compartir algunas experiencias de educación familiar y su importancia en el tratamiento clínico con el propósito de reestablecer las áreas psicológicas y sociales en personas con consumo problemático de alcohol y otras drogas. El estudio se realizó en el centro de especialidad de tratamiento de consumo problemático de alcohol y otras drogas (CETAD), en la Provincia de Manabí, Ecuador. Se asumieron 10 estudios de casos de pacientes en edades de 18 a 25 años, tomando indicadores de medición cualitativa en el análisis comparativo. Se acredita como resultado, la recuperación psico-afectiva de valoración personal y familiar con la incorporación de los participantes a la sociedad y al campo laboral. Se concluye que es de suma importancia la voluntad propia del paciente en tomar el programa para su recuperación, así como la participación familiar como elemento sustantivo que componen las áreas de análisis para su abordaje. PALABRAS CLAVE: Abordaje familiar; abordaje psicodinámico; abordaje cognitivo; abordaje conductual. FAMILY EDUCATION IN THE TREATMENT OF CASES OF ADDICTIONS TO ALCOHOL AND OTHER DRUGS ABSTRACT In this article, we intend to share some experiences of family education and its importance in clinical treatment with the purpose of reestablishing psychological and social areas in people with problematic alcohol and other drug use. The study was carried out in the specialty center of treatment of problematic consumption of alcohol and other drugs (CETAD), in the Province of Manabí, Ecuador. We assumed 10 case studies of patients aged 18 to 25 years, taking indicators of qualitative measurement in the comparative analysis. It is credited as a result, the psycho-affective recovery of personal and family valuation with the incorporation of the participants to the society and to the labor field. It is concluded that it is very important the patient's own will to take the program for recovery, as well as family participation as a substantive element that make up the areas of analysis for its approach. KEYWORDS: Family approach; psychodynamic approach; cognitive approach; behavioral approach.

Inflammatory fibrous hyperplasia: a rare case in a child

ABSTRACT This paper aims to describe an inflammatory fibrous hyperplasia case caused by chronic irritation due to poor dental positioning after trauma. An 11-year-old female patient was sent to a dental specialty center with the complaint of a soft tissue growth in the place of an unerupted maxillary central incisor, causing her behavioral changes becoming more timid. After anamnesis and clinical examination it was noted that tooth 11 was in a vestibular position, covered with a hyperplastic lesion. Surgical treatment was performed and the histopathological exam revealed inflammatory fibrous hyperplasia. Over the course of the follow-up appointments, it was possible to observe improvement on the mentioned tooth and the patient’s satisfaction. In face of the low prevalence of inflammatory fibrous hyperplasia, it is worth mentioning that the tooth positioning, outside its correct alignment in the arch, can cause repeated trauma to the mucosa, and then turning into etiological factor to inflammatory fibrous hyperplasia, affecting even children and adolescents. Thus, the dentistry must be alert to establish a diagnosis and clinical treatment, in addition to monitoring these cases.