Day 2 :
- Pediatric Endocrinology
Saint-Petersburg State Pediatric Medical University, Russia
Anatoly F Romanchishen is a Professor of Surgery and Oncology, Chief of Hospital Surgery and Oncology Department of Saint-Petersburg State Pediatric Medical Academy, Director of St. Petersburg Center of Endocrine Surgery and Oncology, Member of American, European, Asian, and Italian (Honorable), Associations of Endocrine Surgeons, Honored Doctor of Russian Federation.
Introduction: During embryonic development thyroid tissue gradually falls down fromtongue root to the typical thyroid gland’s place. Lingual Goiter emerge in 1 patients of 100.000 population and in 1 (0.03%) of 3000 Thyroid Diseases patient. We observed 8 (0.025%) lingual goiter (LG) of 32022 thyroid diseases patient (1973 - 2019) and 3 of them were operated on. As a result of thyroid tissue (TT) omitting LG, supra – praehyoid - behind and infrahyoid goiter of thyroid remnants along of thyroglossal duct could appeared with (ectopia) or without (dystopia) presence TT in typical place. Indications for Surgical treatment of a LG patients: relapse or profuse bleeding, aggressive groves of LG with dyspnea and dysphagia; suspicions of malignancy, thyrotoxic LG. Thyroid disorders are one of the most common endocrine problems in children and adolescents. Children with thyroid disorders usually present with an enlargement of the thyroid gland (goitre), with or without symptoms of thyroid hormone deficiency or excess. These symptoms are generally insidious in onset, which may delay diagnosis by several weeks to several months. Because a goitre is often the first sign of thyroid disease, the diagnostic considerations can be approached from the perspective of the goitre. By far, the most frequent cause of a goitre is autoimmune thyroid disease, although a benign colloid goitre is also a common cause. The present review focuses on the diagnostic approach to a child with a hypothyroid, hyperthyroid or euthyroid goitre. The most common finding related to thyroid disease is a diffuse enlargement of the thyroid, with the right lobe being frequently larger than the left lobe. The enlargement of the thyroid is generally mediated by an increase in the pituitary-derived thyroid stimulating hormone (TSH) or in antibodies that bind to the TSH receptor, such as the thyroid stimulating immunoglobulins (TSIs) found in Graves disease. Inflammation or infiltration may cause diffuse, symmetrical enlargement, although the gland is usually asymmetric and nodular. The most common inflammatory process is autoimmune thyroiditis
Keywords: Goitre, Hyperthyroidism, Hypothyroidism, Thyroid nodule
Material and Method: Patient 39 years old woman with lingual, suprahyoid and praehyoid thyroid gland goiter (1997). She had tumor mass in the root of tongue, supra - and praehyoid part of the neck from 10 years old. Since 1994 the tumors has increased in size quickly and caused of dyspnea, dysphagia and nasonnement voice changing. CT scans of the patient neck has shoved: LG narrowed of oropharings, TT is absent in typical place. Surgery of patients (August 08. 1997). submandibular approach has find LG, suprahyoid, praehyoid goiters and was take it out 04. O8. 1997. 2.5 month later after patients operation was performed Tc99m scintigram - radiodrug accumulation was absent on the neck. She takes the replacement LT4 therapy.
Conclusion: 1. Wait-and-see policy of lingual goiter patients treatment can be dangerous because suffocation might occur.
2. Lingual goiter would be successfully removal through neck submandibular approach with lingual root resection.
Saint-Petersburg State Pediatric Medical University, Russia
Kristina Vabalayte is a Professor of Surgery and Oncology, Department of Hospital Surgery of Saint-Petersburg Pediatric Medical University, Saint Petersburg Center of Endocrine Surgery and Oncology, Russia.
Background: For patients with differentiated thyroid carcinoma (DTC), the effect of radioactive iodine (RAI) therapy on gonadal and reproductive function is an important consideration.
Objective and Methods: 127 children were operated on thyroid in case of DTC during 1975-2015. 87 pts were treated by RAI (1-13 times). Average age is 15 years (4-18). Histological types of DTC were papillary (69%), follicular (27%) and other (4%). Average follow up period is 3 year (2-40). We analyzed effect of therapeutic RAI on sex steroid level; on ovarian function, menses, ovulation in women; sperm in men; future fertility; pregnancy outcomes.
Results: Early side effects (during 1st week after RAI) includednausea and vomiting (29%), sialoadenitis (22%), temporal bone marrow dysfunction (6%). Late side effects included permanent salivary glands’ dysfunction (2%), permanent bone marrow dysfunction (4%), lung fibrosis (5%), second tumors – leucosis, breast cancer (4%), and fertility disorder (7%). Fertility was analyzed in 78 pts. Sterility (2%), amenorrhea (4%), changes in menstrual period (5%), miscarriage (4%).
Conclusion: RAI should be prescribed only for indications. Sexual cell should be cryopreserve before RAI.
Baylor College of Medicine, USA
Farida Abid serves as an Assistant Professor in the Department of Pediatric Neurology at Baylor College of Medicine. She is a graduate of Dow Medical College in Karachi, Pakistan. She then moved to the USA. She completed her Pediatric Residency at the University of Medicine and Dentistry at New Jersey (UMDNJ), followed by a Pediatric Neurology fellowship at Baylor College of Medicine. She has worked at University of Oklahoma (OUHSC) as an assistant Professor (2006-2011). Also, she is a graduate of the OUHSC Faculty Leadership Program. She joined Baylor College of Medicine (BCM) in 2011. She is board certified in Neurology with a special qualification in Child Neurology.
Spinal Muscular Atrophy (SMA) is a very severe neurodegenerative disease which causes progressive muscle atrophy and weakness due to loss of the anterior horn cells in the spinal cord and the lower brain stem nuclei. SMA is second most common autosomal recessive disorder and the most common genetic cause of death in infancy. It is caused by deficiency of survival of motor neuron (SMN) protein due to pathogenic variant in the SMN1 gene. SMA is classified clinically into four subtypes based on the age of onset and maximum motor function achieved. SMA type 1 (most severe form) is present with weakness and hypotonia before six months of age. Type II manifest between ages six and 12 months. Type III manifests between ages 18 to 36 months. Type IV (adult onset) develops muscle weakness in second or third decade. There is no cure for SMA and until recently only supportive treatment was available but the approval of Nusinersen and Zolgesma, has revolutionized the outcome of SMA. Nusinersen (Spinraza) is an antisense oligonucleotide for the treatment of SMA that increases the production of full- length SMN protein. Zolgesma is a gene therapy that restores the deleted SMN1 gene. Both Nusinersen and Zolgesma have demonstrated significant and clinically meaningful efficacy on the achievement of motor milestones and measures of motor function, as well as favorable safety across all types of SMA and significantly greater event-free survival in infants with infantile-onset SMA. It’s important to recognize some of the early signs and symptoms of SMA and diagnose presymptomatic patients by Newborn screen for better outcome of this devastating disease.
1Oswaldo Cruz Foundation, Brazil
Roberta Ivanira Silva do Carmo has her expertise in review manuscript and providing valuable comments for international journals. Her passion in work in the Neonatal Intensive Care Unit (NICU) and pediatric Intensive Care allows to develop research aimed at contributing for improving health care through the her observation during the provision of assistance in intensive care. She work on the development of new research related to congenital diaphragmatic hernia in children and newborn. Her expertise is in developing research about retrospective cohort and data collection based on the review ofmedical records.
Introduction: Congenital diaphragmatic hernia (CDH) is associated with a failure in the fusion of the caudal pleuroperitoneal membranes that form the diaphragm, resulting in a defect of continuity, with potential thoracic migration of the abdominal structures under formation, resulting in compression of the lungs.1---3. Therefore, the aim of this study was to describe and analyze the prognosis of children during the first year of life with a diagnosis of congenital diaphragmatic hernia admitted between the years 2005 and 2015 in the Neonatal Intensive Care Unit.
Method: In a retrospective cohort, 129 children with a diagnosis of congenital diaphragmatic hernia were studied. The prognostic factors were analyzed, whereupon prenatal, delivery, and postnatal exposure variables were associated with death during the first year of life. The odds ratio and the confidence interval (95% CI) were calculated for all the studied variables, using the chi-squared test and Student’s t-test.
Results: The study included 129 children hospitalized from January of 2005 to December of 2015. Seventy-nine (61%) patients died, 50 survived, and 33 had other associated malforma-tions. Among the prognostic factors, the following were significant and increased the chance of death: polyhydramnios (p = 0.001), gestational age of the earliest diagnosis (p = 0.004), asso-ciated congenital abnormalities (OR: 3.013, p = 0.022), pO2 of the first gasometry (p = 0.000), pCO2 of the first gasometry (p = 0.000), presence of pulmonary hypoplasia (OR: 3.074, p = 0.000), use of preoperative vasoactive drugs (OR: 2.881, p = 0.000), and use of nitric oxide (OR: 1.739, p = 0.000). The presence of only intestines in the hernia content was a protective factor (OR: 0.615, p = 0.001).
Conclusion: The mortality in the first year of life in patients with congenital diaphragmatic hernia in this study was 61% in the years 2005---2015. Among the prognostic factors that demonstrated a significant effect, pulmonary hypoplasia had the greatest impact.
Jamia Millia Islamia, India
Dr Vivek Mehta has completed his graduation from Kurukshetra University and post-graduation (M.D.S) from Faculty of Dental Sciences, King George Medical University, India in Pediatric Dentistry on merit basis. He was a distinction holder in graduation, won best table clinics by IDA and was the first Indian to receive Henry M. Thornton Fellowship from SCADA, U.S.A i.e. Student Clinician American Dental Association for my post-graduate studies in 2006 and also rewarded with Fellowship from Pierre Fauchard Academy, USA in 2013. He has completed Diploma in Hospital administration from National Institute of Health and Family Welfare, New Delhi, and Post Graduate Diploma in Child Rights Law from National Law School University of India. Currently he is working as Professor in a Central Government University in New Delhi, India with a total teaching and clinical work experience of more than 12 years.
Coronavirus disease 2019 (COVID-19) is an infectious disease which has caused great impact on the healthcare systems across the globe. Despite worldwide efforts to prevent and slow down transmission of the viral pandemic, outbreak could not be controlled. All the healthcare professionals are at risk of contracting the disease and dentists are at increased risk of exposure.
It has affected people of all age-groups and child patients are no exception. Therefore pediatric dentists have an important role to play in the prevention of this viral pandemic. Aim of this webinar presentation is to create awareness amongst the pediatricians, pediatric dentists and general dental practitioners regarding management protocols, how to minimize risk to child patients in pandemic, prevent infection and to slow transmission of Covid-19.