BackgroundDiagnosis of pulmonary tuberculosis (PTB) is difficult in infants and young children. For microbiological confirmation of PTB children, sequential gastric lavage (GL) is recommended. Induced sputum (IS) may be an alternative or complementary tool, but the information is limited in children in developed countries. The aim of this study is to assess the safety and diagnostic yield from IS combined with GL for PTB diagnosis in non-HIV infected children.MethodsThe study involved 22 children with suspected PTB admitted to the Getafe Hospital from January 2007 to May 2011. IS and GL were performed on three consecutive days, according to a standardized protocol. In all samples, BK staining, culture and PCR were carried out, including Genotype MTBDR plus for resistance to INH-RIF (Isoniazid-Rifampin) since 2008. A preliminary analysis of an ongoing prospective study is presented.ResultsMedian age was 72 months (range 1 month to 14 years of age). Seven (33%) were ≤ 5 years of age. Seventeen were clinically diagnosed of PTB based on positive PPD and radiological criteria. Microbiological confirmation was achieved in 10 (58.8%) by either GL or IS. M. tuberculosis was identified by GL in 8 children (47.1%) and by IS in 7 (41.2%). One infant (2 IS samples) had transient oxygen desaturation recovered spontaneously.ConclusionsIS appears to be safe and well tolerated by children for diagnosis of PTB and is more convenient. Increasing the diagnostic yield of PTB in children with PTB may be a complementary technique. Largest studies are necessary to define the role of IS in paediatric PTB.

We present simple parametric equations in terms of Jacobi elliptic functions that provide a realistic model of abnormal variations in size which maintain the biconcave shape of a normal erythrocyte (anisocytosis) and abnormal variations in shape which maintain the original volume of the erythrocyte (poikilocytosis), as well as continuous deformations from the normal to the altered shapes. We illustrate our results with parameterizations of microcytes, macrocytes, and stomatocytes, and we apply these parameterizations to the numerical calculation of the induced transmembrane voltage in microcytes, macrocytes, and stomatocytes exposed to an external electromagnetic field of 1800 MHz.

We study the influence of an external electromagnetic field of 1.8 GHz in the formation or disaggregation of long rouleau of identical erythrocyte cells. In particular we calculate the variation of the transmembrane potential of an individual erythrocyte illuminated by the external field due to the presence of the neighboring erythrocytes in the rouleau, and compare the total electric energy of isolated cells with the total electric energy of the rouleau. We show that the polarization of the external electromagnetic field plays a fundamental role in the total energy variation of the cell system, and consequently in the formation or disaggregation of rouleau.

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PFAPA syndrome is the most common recurrent periodic fever disorder described in childhood. Its genetic background has not been elucidated yet. Our contribution with two siblings affected with PFAPA syndrome further support the genetic basis for the entity.