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1.
Med Ultrason ; 25(4): 453-465, 2023 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-37778029

RESUMO

Since the publication of Professor Reinhard Graf's work in 1980, Graf's technique has become the gold standard for screening Developmental Dysplasia of the Hip (DDH) in many European and non-European countries. Despite the fact that it is supported by robust literature evidence, there is criticism about its reliability and reproducibility, questioning severalaspects of the diagnostic procedure. There is, however, concern, based on recent literature, about the quality and reliability of the published data, which may, in many cases, be based on inadequate scans, and therefore any conclusions drawn have to be questioned. The aim of this review is to demonstrate the most important aspects of Graf's technique, to clarify the potential sources of confusion and to flag up the most common errors and mistakes made, either during the ultrasound examination, or during the reporting procedure. Furthermore, this review can be used as a guide for reviewers and editors and should help to enhance the quality control of publications on this subject.


Assuntos
Luxação Congênita de Quadril , Humanos , Luxação Congênita de Quadril/diagnóstico , Reprodutibilidade dos Testes , Ultrassonografia/métodos , Estudantes
2.
Ital J Pediatr ; 46(1): 150, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33036652

RESUMO

This consensus document has been prepared by a multidisciplinary group of experts (Paediatricians, Radiologists, Paediatric Orthopaedics) and it is mainly aimed at paediatricians, hospitals and primary care providers. We provide recommendations for the early diagnosis and treatment of Developmental Dysplasia of the Hip (DDH) and indications on its management.


Assuntos
Displasia do Desenvolvimento do Quadril/diagnóstico , Diagnóstico Precoce , Consenso , Humanos , Recém-Nascido
3.
Ultraschall Med ; 40(4): 454-464, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31195424

RESUMO

In September 2018, an international meeting of doctors of various disciplines, with expertise in the detection and treatment of DDH, was held in Csolyospalos, Hungary. The aim was to achieve consensus on the detection and early treatment of the condition and to develop a standardized system of teaching and training for hip ultrasound. There was strong agreement that US screening is essential. Specifically the Graf technique was selected as the technique of choice. Universal US screening was strongly favored. Screening should be carried out as soon as possible, but not later than the sixth week of age. US screening is cost-effective, does not result in overtreatment, and contributes to a reduction of long-term consequences. The essential principle of treatment is timely application of a device to achieve reduction, retention and maturation, by holding the hips in flexion, and a safe degree of abduction. It was agreed that the effectiveness of any screening policy depends on the correct scanning technique. Therefore, standardization of teaching and training of the Graf technique is mandatory. A unified teaching policy and materials should be developed for this purpose. Certification, re-certification and audit were discussed. The group, which has been formalized as the International Interdisciplinary Consensus Committee On DDH Evaluation (ICODE), will continue to meet and work towards establishing international consensus on DDH, standardizing and developing teaching and training of the Graf technique for hip US, and maintaining standards for detection and management.


Assuntos
Luxação Congênita de Quadril , Ultrassonografia , Consenso , Luxação Congênita de Quadril/diagnóstico por imagem , Humanos , Hungria , Recém-Nascido , Triagem Neonatal
4.
Pediatr Allergy Immunol ; 16(2): 145-50, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15787872

RESUMO

Despite numerous studies demonstrating an association between asthma and many other chronic conditions and signs of Chlamydia pneumoniae (Cp) infection, the role of Cp in the pathogenesis of these illness remain still unclear. We investigated the prevalence of Cp antigen in the upper airways and the prevalence of detectable Cp serum antibodies in an unselected population of 207 9-yr-old schoolchildren. We also sought the presence of asthma, chronic or recurrent respiratory symptoms by means of questionnaire completed by the parents. Nasal aspirate, blood sampling and allergen skin prick tests were also performed. None of the children had obvious signs of acute infection at physical examination. Cp DNA was detected in nasal aspirates from 20 of the 207 children tested and serum IgG antibodies for Cp in 68 children. No association was found between atopy or history of atopic illness and the presence of Cp DNA or antibody production. This finding is explained by the fact that our study was conducted in an unselected childhood population, inherently including few children with asthma. A strong association between the status of antigen carrier and the presence of detectable Cp serum immunoglobulin (Ig)G or IgM suggests that subjects with detectable Cp antibodies have an impaired ability to eliminate this pathogen when infected. Because Cp eradication requires a strong Th1 lymphocyte response, the previously proven association between Cp and asthma, might reflect the known association of asthma with Th2-oriented lymphocytic activity.


Assuntos
Asma/epidemiologia , Infecções por Chlamydia/complicações , Animais , Anticorpos Antibacterianos/sangue , Antígenos de Bactérias/análise , Asma/etiologia , Criança , Infecções por Chlamydia/imunologia , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/imunologia , Doença Crônica , DNA/análise , Feminino , Humanos , Hipersensibilidade Imediata/epidemiologia , Hipersensibilidade Imediata/etiologia , Imunoglobulina G/sangue , Masculino , Mucosa Nasal/microbiologia , Reação em Cadeia da Polimerase
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