The interest and application of musculoskeletal ultrasound (MSUS) in juvenile idiopathic arthritis (JIA) are increasing. Numerous studies have shown that MSUS is more sensitive than clinical examination for detecting subclinical synovitis. MSUS is a well-accepted tool, easily accessible and non-irradiating. Therefore, it is a useful technique throughout JIA management. In the diagnostic work-up, MSUS allows for better characterizing the inflammatory involvement. It helps to define the disease extension, improving the classification of patients into JIA subtypes. Moreover, it is an essential tool for guiding intra-articular and peritendinous procedures. Finally, during the follow-up, in detecting subclinical disease activity, MSUS can be helpful in therapeutic decision-making. Because of several peculiarities related to the growing skeleton, the MSUS standards defined for adults do not apply to children. During the last decade, many teams have made large efforts to define normal and pathological US features in children in different age groups, which should be considered during the US examination. This review describes the specificities of MSUS in children, its applications in clinical practice, and its integration into the new JIA treat-to-target therapeutic approach.

BACKGROUND: Knowledge concerning variability of the facial nerve trunk (FNT) direction after its exit through the stylomastoid foramen is of a great clinical significance for maxillofacial surgeons, otorhinolaryngologists, oncologists, specialists in plastic and aesthetic surgery. The aim of our study was to establish the variation of the FNT direction and its peculiarities depending on the branching pattern, gender, anthropometric type and side of the head.
METHODS: The direction of the FNT and its branching pattern were studied on 75 dissected hemifaces of adult formalised cadavers (59 male/ /16 female), and the morphometry of the FNT length, width and bifurcation angle was carried out.
RESULTS: Seven branching patterns of the facial nerve were established: type I - 18.7%, type II - 14.7%, type III - 20%, type IV - 14.6%, type V - 5.3%, type VI - 18.7%, and type NI - 8% (bizarre types). The FNT had a descending direction in 73.3% of cases; ascending FNT - 9.3% (including 5.3% of very short diffuse branching trunks and 1.3% of arch-shaped FNT); horizontal FNT - 10.7%; number variants - 6.7%. The male/female ratio of the descending FNT was 69.5%/87.4%; ascending - 10.2%/6.3%; horizontal - 11.9%/6.3%; number variants - 8.4% (only in male). The right/left ratio of the descending FNT was 62.9%/82.5%; ascending - 11.4%/7.5%; horizontal - 11.4%/10%; number variants - 14.3% (only on the right side). The ratio of the descending FNT in mesocephalic type (MCT)/brachycephalic type (BCT)/dolichocephalic type (DCT) was respectively 70.6%/100%/66.7%; ascending - 12.1%/0%/0%; horizontal - 12.1/0%/11.1%. Numerical variants in MCT - 5.2%, in DCT - 22.2%. The mean number of FNT in MCT/BCT/DCT was respectively 1.07/1.0/1.22.
CONCLUSIONS: Three main directions are characteristic of the FNT: the descending, ascending and horizontal ones, which vary depending on the branching pattern, gender, shape and side of the head.

A new pandemic caused by SARS-CoV-2 raised new challenges for the worldwide healthcare system, involving the pediatric field since children own certain peculiarities that caused a different reaction to this infection as compared to adults. We report two cases of COVID-19 in two pediatric patients, a 6-month-old male infant and a 15-year-old female teenager in order to underline the age-related differences in terms of clinical manifestations. Thus, the 6-month-old male infant was admitted in our clinic presenting fever, rhinorrhea and diarrhea for ~24 h. Taking into account that both parents presented respiratory manifestations, nasopharyngeal/oropharyngeal swab-based polymerase chain reaction tests for SARS-CoV-2 were performed, and the test came back positive for the parents and inconclusive for the infant. Nevertheless, the infection was confirmed also in the child by the second test. The symptoms resolved in the 2nd day of admission with symptomatic treatment. The 2nd case, a 15-year-old female teenager, presented to the emergency department with fever, cough and shortness of breath (O2 saturation 84%). The chest radiography pointed out multilobar impairment. The nasopharyngeal/oropharyngeal swab-based polymerase chain reaction test for SARS-CoV-2 infection was positive. She was admitted to the intensive care unit for 3 days, and the evolution was favorable with anti-viral therapy. The pediatrician\'s awareness regarding both asymptomatic and atypical cases is vital for decreasing the transmission of this novel life-threatening condition.

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Spina bifida is a common congenital anomaly of the nervous system. It is frequently associated with significant morbidity and sometimes mortality in affected children. In this paper, we review the clinico-epidemiological pattern, peculiarities, and therapeutic challenges of this condition in our practice setting.
This is a retrospective study of all cases of spina bifida managed from July 2000 to March 2016 at a tertiary health facility located in the southwest region of Nigeria. Relevant information was retrieved from the medical records. The data was collected using a pro forma and analyzed with SPSS version 22.
Data from 148 patients was reviewed and analyzed. There were 78 males and 70 females. Only 5.8% of these children were delivered at the health institution. A fifth (20%) of the patients were first born of their mothers. The mean maternal age was 29 years. Few (10.1%) mothers use folate medication prior to conception and only 58% of the mothers use folate during antenatal care. Mean duration of pregnancy was 38 weeks. The most common anatomical site was lumbosacral region (74.3%) while the most common pathology was myelomeningocele 80.4%. Mean age at surgery was 88.68 h. Mean duration of surgery was 92.8 min. Mean follow-up duration was 46.8 weeks. As many as 59% of the patients had some neurologic improvement noticed during follow-up clinic visits.
Spina bifida occurs frequently in our environment. Low socio-economic status and poor antenatal clinic visits contributes significantly to its occurrence.