30 research outputs found
Association of brucellosis with renal tubular and glomerular damage in children in Turkey
No full textBrucellosis is a multisystem disease that may present with a broad spectrum of clinical manifestations. Until now, no studies have been performed on renal tubular disorders in patients with brucellosis. The present study aims to investigate renal tubular disorders in patients with brucellosis. This prospective case–control study includes a total of 31 brucellosis patients (Group 1) and 30 healthy controls (Group 2) matched for age and sex. Renal tubular functions of children who were diagnosed as having brucellosis in outpatient pediatric clinics were evaluated. First-morning urine samples were collected from Group 1 and Group 2 at the same time. Urea, creatinine, potassium, sodium, and phosphorus were determined in serum and urine by an autoanalyzer. Tubular reabsorption and excretion of urine electrolytes were calculated using the related formulas. Patients with brucellosis had significantly lower levels of tubular reabsorption of phosphorus and serum phosphorus than those of the control group. Furthermore, urine sodium and serum potassium levels and fractionated sodium excretion of brucellosis patients were significantly higher than healthy control group. Estimated glomerular filtration rate was remarkably higher in the patient group (P < 0.001).We concluded that tubular and glomerular functional parameters demonstrate deterioration in patients with brucellosis compared to those in healthy participants
Frequency of Vitamin D Deficiencies in Children Who Living in the South-East of Turkey Region with Plenty of Sunshine
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Urine Flow Cytometry in the Diagnosis of Urinary Tract Infection
No full textObjectives To determine the cut-off value of bacteria with urine flow cytometer in diagnosing urinary tract infection. Methods From a total of 546 patients admitted to the hospital with urinary tract infection (UTI), two urine samples were obtained for each patient. Urine samples in sterile containers were divided into two; first for urine culture and second for simultaneous measurement with UF-1000i flow cytometry device. The presence of a single type of bacteria over 10(3) CFU/mL in urine culture was accepted as UTI. Results Of 546 patients, 210 (38.5%) were boys and 336 (61.5%) were girls. There was no growth in 489 (89.5%) of the urine specimens and 57 (10.4%) samples showed growth (>10(3) CFU/ml). A threshold of 10 bacteria/L in flow cytometry (sensitivity = 100%) showed the best compatibility with culture. Diagnostic values in terms of sensitivity (100%), specificity (43.5%), negative predictive value (100%) and positive predictive value (17.7%) were satisfactory. Conclusions The UF-1000i flow cytometer can give results quickly and exclude UTI using the determined number of cut-off bacteria at low cost. Thus, if Sysmex UF-1000i is used, quick and accurate results can be obtained and unnecessary laboratory tests can be prevented. Also, patient convenience can be increased
Are urodynamic studies really necessary in voiding dysfunction in children? [Çocuklarda işeme bozukluklarında ürodinamik çalışmalar gerçekten gerekli mi?]
No full textAim: Urodynamic examination is considered the most reliable, but also a quite invasive tool for the diagnosis of voiding dysfunctions in children. In this study, we evaluated the role of invasive urodynamics in the diagnosis of lower urinary tract dysfunction in children. Methods: One thousand one hundred twenty seven patients underwent urodynamic studies in the pediatric nephrology clinic in Ege University Faculty of Medicine between March 2011 and March 2016. A retrospective analysis of data including symptoms of voiding dysfunction (urinary frequency, urgency, nocturia and/or urge incontinence) and findings of physical examination, urodynamics and ultrasonography was performed. Results: Two hundred and seventy-seven (30.8%) boys and 620 (69.1%) girls with a mean age of 7.52 (±2.6) years underwent urodynamic studies. The most common abnormality was overactive bladder detected in 630 patients (70.2%). 19.9% (n=179) of the participants had dysfunctional voiding, while 9.8% (n=88) had normal results. Conclusion: A small and frequent voiding pattern, enuresis nocturna with daytime symptoms, and postvoid urinary residual volume were the common findings seen in patients with overactive bladder. In addition, dyssynergic voiding and a bladder with large capacity but residual volume after voiding were also commonly found. To that end, we may use ultrasound, clinical examination, symptoms and voiding frequency as first-line diagnostic tools. © 2018 by The Medical Bulletin of University of Health Sciences Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayınevi
Relationship of Insulin Resistance to Vitamin D Status in Children with Nondiabetic Chronic Kidney Disease
No full textInsulin Resistance is common in patients with mild-to-moderate stage chronic kidney disease (CKD), even when the glomerular filtration rate is within the normal range. This study aimed to investigate the association of IR and 25-hydroxyvitamin D levels. In this study, we evaluated the frequency of IR in predialysis patients and the association with 25-hydroxyvitamin (OH)D levels. A total of 32 non-diabetic patients with predialysis were included in the study. Homeostasis model assessment for insulin resistance (HOMA-IR) index was calculated to show presence of IR. Data were analyzed with the Statistical Package for the Social Sciences (SPSS) program version 13.0 (SPSS Inc, Chicago, Ill, USA) using the Chi-square, Student t-test, and logistic regression analysis. Nineteen of 32 subjects (59.4%) were detected to have IR. There was no consistent relationship was detected between IR and glomerular filtration rate, body mass index, and blood pressure in chronic kidney disease (CKD). However; significant difference was detected in 25(OH)D levels with IR in CKD (P = 0.49). The regression analysis showed that 25(OH)D was an independent predictor of IR with an odds ratio of 1.2. In our study, we demonstrated that IR was high in different stages of CKD. Insulin-resistance in non-diabetic CKD was correlated with 25(OH)D levels. 25(OH) vitamin D levels can play a significant role in the development of IR in pediatric patients with CKD. This is important for the early detection and intervention of vitamin D deficiency thereby preventing potentially future complications related to IR
The Role of Neonatal Sepsis in the Development of Allergic Diseases in Childhood
No full textAim: We aimed to demonstrate the effect of neonatal sepsis on the development of allergic diseases at later ages. Materials and Methods: For the study, 126 children who were diagnosed with sepsis in the neonatal period, and hospitalized between 2001 and 2003 were recruited, and divided into two groups. Group one consisted of children who had sepsis in the neonatal period. Group two children were chosen from among group one's siblings as controls in whom genetic and environmental factors leading to allergic diseases were similar. The prevalence of allergic diseases were compared between the two groups. The Turkish version of the International Study of Asthma and Allergies in Children questionnaire was used via the face-to-face methodology. Additionally, total blood count was studied for potential eosinophilia, total immunoglobulin E (IgE) levels were measured, and skin prick tests were performed on each subject. Results: Total IgE levels and sensitivity to Dermatophagoides pteronyssinus, Dermatophagoides farinea were significantly lower (p<0.05) in group one. Also the prevalence of asthma and allergic symptoms were significantly less common (p<0.05) in the first group. Interestingly, we found no significant difference in the prevalence of allergic rhinitis and atopic dermatitis between the two groups. Conclusion: The present study highlighted that contact with severe infections such as sepsis in the neonatal period can be a cause of decreased sensitivity to environmental allergens and the prevalence of asthma in childhood
Renal abscess in a previously healthy 4-year-old girl: A case report
No full textRenal abscess is uncommon in childhood. The common manifestations include fever, lumbar pain, abdominal pain and occasional flank mass. Renal ultrasonography enables us to achieve an early diagnosis, however; it may still be insufficient to distinguish it from pyelonephritis. Renal abscesses are usually associated with different predisposing conditions. In the present report, we aim to describe a case of a previously healthy child who developed a renal abscess.Renal abscess is uncommon in childhood. The common manifestations include fever, lumbar pain, abdominal pain and occasional flank mass. Renal ultrasonography enables us to achieve an early diagnosis, however; it may still be insufficient to distinguish it from pyelonephritis. Renal abscesses are usually associated with different predisposing conditions. In the present report, we aim to describe a case of a previously healthy child who developed a renal abscess
Ultrasound Doppler renal pulsatility index is a predictive marker of arterial stiffness in children with solitary functioning kidney
No full textIntroduction: Patients with solitary functioning kidney (SFK) have glomerular hyperfiltration, hypertension, proteinuria and impaired renal function resulting in microvascular atherosclerotic abnormalities. This condition leads to an increase in arterial stiffness. In this study, we aimed to investigate the usefulness of noninvasive renal Doppler ultrasonography hemodynamic parameters in demonstrating arterial stiffness in pediatric patients with SFK. Methods: The study included 59 children aged 6-18 years who were diagnosed with SFK. Demographic, biochemical, anthropometric, and blood pressure data were recorded. The renal Doppler ultrasound hemodynamic parameters renal resistive index (RRI), renal pulsatility index (RPI), carotid femoral pulse wave velocity (cfPWV), central augmentation index (cAIx) and carotid intima media thickness (cIMT) were evaluated. Results: Eighteen (30.5%) cases with acquired SFK and 41 (64.5%) cases with congenital SFK were detected. Central augmentation indices were higher in children with congenital SFK than in children with acquired SFK (p = 0.038). CkiDeGFRSCrCysC was lower in patients with acquired SFK (p = 0.011). LDL cholesterol levels were higher in children with acquired SFK (p = 0.018). We found a significant correlation between RPI and cfPWV with a correlation coefficient (r) of 0.321 and a statistically significant p value of 0.013. Conclusion: Congenital SFK is associated with increased microvascular atherosclerotic burden. RPI assessment with renal Doppler ultrasound may be a noninvasive method to identify arterial stiffness
