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Sleeping disorders are frequently encountered in infants and adolescents. They often induce a distress in the family, an individual sadness possibly leaving at time to maltreatment. In the normal infant or the medically fragile infant due to prematurity or an acute episode, complaints from the patient or family sources force the medical team to find an explanation or a treatment, which are not always adequate. In other conditions such as asthma, obesity, anorexia nervosa, autism, cerebral palsy, hyperactivity, the sleeping disorders may be so unnoticed or remain insufficiently investigated. Globally, in this domain, the clinical description is often imprecise and sleep studies underused. a more accurate assessment should lead to a better educative approach and more appropriate therapy. Source


Kouame N.,Service de radiologie | Akaffou E.,Service de Pediatrie Neonatologie | N'Goan-Domoua A.M.,Service de radiologie | Konan A.N.,Service de radiologie | And 3 more authors.
Journal Africain d'Hepato-Gastroenterologie | Year: 2012

Objective: To report a rare case of extrapulmonary tuberculosis (hepatic tuberculosis) and demonstrate the role of the ultrasound in its early detection, its precise diagnosis and in the monitoring of its treatment. Method: We performed an abdominal ultrasound to a 12-year-old, immuno-competent teenager, complaining about chronic abdominal pain evolving for 8 months, without any notion of tuberculous contagium and presenting signs of tuberculous impregnation. The ultrasound examination was performed by means of an echo-doppler ultrasound device (Logic 400) of General Electric, provided with 2 probes (3.5 MHz and 7.5 MHz). Results: The abdominal ultrasound found, a multimicronodular hepatomegaly. Micronodules were homogeneous hypoechogenics, measuring between 3 and 4 mm in diameter and were spread in all the hepatic parenchyma. An ascites located in the pelvis was objectivized. There were neither adenopathies nor peritoneal nodules. The diagnosis of hepatic tuberculosis was evoked and confirmed by a hepatic punch-biopsy under ultrasound guidance. The patient was treated and a monthly ultrasound monitoring was performed. The disappearance of nodules and the ascites was obtained at the end of the 4th month of the treatment. That of the hepatomegaly is obtained one month later. Conclusion: Ultrasound examination plays a very important role in the early detection of the hepatic tuberculosis, its precise diagnosis and the surveillance of the treatment. During its realization in a context of chronic abdominal pain at the child, the diagnosis of hepatic tuberculosis should be evoked in front of a multi-micronodular hepatomegaly, even at the immuno-competent child. © Springer-Verlag 2012. Source

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