... to detect possible risk factors for UC and UTI following pediatricrenal Tx and effect of these complications on outcome... higher in girls (51.4% vs 30.1%; P = .001) and in children with urological causes of ESRD (51.5% vs 30.7%; P = .049... with cystoplasty while UTIs were significantly higher in girls and children with urological causes of ESRD.
AbstractText: To present our technique for staged urethroplasty with buccal mucosa graft AbstractText: The patient presented is a 42 year-old male with a history of congenital hypospadias repaired as a child. He developed a penile urethral stricture at age 30 and was managed with self intermittent dilation. Recently, dilation became more difficult, and he was referred for reconstruction.
Hypospadias (5), Pathologic Constriction (5), Urethral Stricture (3), more mentions
Minimally invasive ureteral reimplantation is an attractive and useful tool in the armamentarium for the management of complicated vesicoureteral reflux (VUR). Subureteric dextranomer/hyaluronic acid injection, laparoscopic extravesical ureteric reimplantation and pneumovesicoscopic intravesical ureteral reimplantation with or without robotic assistance are established minimally invasive approaches to management of VUR. The high cost and the limited availability of robotics have restricted accessibility to these approaches. Laparoscopic and/or robotic ureteral reimplantation continues to evolve and will have a significant bearing on the management of complicated VUR in infants and young children.
Abstract: Ureteral stenting after pediatricrenal transplantation serves to prevent obstruction and urinary leakage, but can also cause complications. This study compares the complication rates of both methods. Data were retrospectively collected at Erasmus MC, Rotterdam, the Netherlands (splint group, n = 61) and Hospital for Sick Children, Toronto, Canada (JJ catheter group, n = 50.
... ESRD) of valve ablation alone versus ablation followed by additional urinary diversion were compared among children with chronic kidney disease stage 3 (CKD3) due to posterior urethral valves (PUV ... 0.61) were predictive of likelihood to progress to ESRD AbstractText: Urinary diversion following valve ablation in children with CKD3 associated with PUV may temporarily delay progression to ...
We report a case of late presentation of congenital diaphragmatic hernia in a child who presented to the emergency department with abdominal pain and respiratory distress. The usual and unusual presentations of congenital diaphragmatic hernia in older children and their possible complications are discussed..
In an article recently published in Pediatric Nephrology, evaluation of a large series by Mehler and colleagues confirms the improved prognosis, showing a survival rate of 32 of 38 (84. In addition, only 12 of 35 (34%) neonates required renal replacement therapy. In five of these 12 children the dialysis could be terminated after the neonatal period.
To promote the standardization of nephro-uroradiological terms used in children, the European Society of Paediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatricurology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication between different clinicians involved in pediatricurology and nephrology.
OBJECTIVES: Accurate interpretation of ano-genital examination findings in the context of suspected child and adolescent sexual abuse/assault is essential, as misinterpretation has significant child protection and criminal justice implications. A consensus approach to the interpretation of ano-genital examination findings is widely utilized to support accurate diagnosis; however, a large-scale study using this standardized approach is lacking. The objectives of this study are to: 1) determine the proportion of ano-genital examinations for sexual abuse concerns with findings diagnostic of trauma and/or sexual contact; 2) determine whether frequency of diagnostic findings varies by age, gender, timing of examination; and 3) characterize diagnostic findings.
METHODS: Retrospective records of children aged 0-18 years evaluated for sexual abuse/assault were reviewed. Case details of 3569 patients were extracted and ano-genital examination findings were re-interpreted using a published consensus approach(1).
RESULTS: Ano-genital examination findings diagnostic of trauma and/or sexual contact were present in 173 of 3569 patients (4.9%). The prevalence of diagnostic findings was significantly higher in adolescents than in children under 12 years of age (13.9% vs. 2.2%), in females versus males (5.7% vs. 1.5%) and in examinations within 72 hours for children under 12 (14.2% vs 4.5%). Acute injuries were the most common type of diagnostic finding.
CONCLUSIONS: Diagnostic findings are present in a small proportion of children and adolescents examined for suspected sexual abuse/assault. It is essential that practitioners interpreting examination findings be adequately trained and familiar with the current consensus approach and aware of case characteristics associated with higher likelihood of findings.
BACKGROUND: Acute kidney injury (AKI) is a common complication of cardiopulmonary bypass surgery (CPB) in children. Several promising postoperative AKI biomarkers have been identified, but no preoperative biomarkers are available. We evaluated the association of urinary uromodulin (uUMOD) with postoperative AKI.
METHODS: One hundred and one children undergoing CPB were enrolled. Urine was collected prior to CPB, and AKI was defined as ≧50% increase in serum creatinine from preoperative baseline within 48 h of surgery.
RESULTS: Forty-seven patients (47%) developed AKI, and 92% of participants in the lowest quartile of preoperative uUMOD concentrations developed AKI compared with 8% in the highest quartile. Patients with preoperative uUMOD levels in the lowest quartile had 132.3× increased risk of postoperative AKI versus the highest quartile. Raw uUMOD levels were significantly lower in patients with AKI vs. no AKI. Significance was unchanged after correcting uUMOD levels for urinary creatinine. Receiver operating characteristic analysis showed preoperative uUMOD strongly predicted postoperative AKI, with area under the curve (AUC) 0.90. Stepwise logistic regression analysis revealed a model combining uUMOD, and bypass time predicted AKI at p<0.001. Neither Risk Adjustment for Congenital Heart Surgery 1 (RACHS) score nor age improved the model's ability to predict AKI. Independent analysis demonstrated that while bypass time was associated with AKI, the predictive ability of bypass time (AUC 0.77) was less than that of preoperative uUMOD levels (AUC 0.9).
CONCLUSIONS: Children with lowest preoperative levels of uUMOD have greatly increased risk of AKI post-CPB. If uUMOD were used to risk-stratify patients undergoing CPB, clinical measures could be taken to minimize AKI development.
AbstractText: To evaluate outcomes of congenital solitary functioning kidney (SFK) in early childhood AbstractText: A retrospective study of 32 children diagnosed in utero ... utero and might serve as a prognostic indicator for normal renal function after birth.Journal of Perinatology advance online publication, 26 October 2017; doi:10.1038/jp.2017.143 ...
AbstractText: To assess trends in the duration of intravenous (IV) antibiotics for urinary tract infections (UTIs) in infants ≤60 days old between 2005 and 2015 and determine if the duration of IV antibiotic treatment is associated with readmission AbstractText: Retrospective analysis of infants ≤60 days old diagnosed with a UTI ...
Urinary tract infection (UTI) is a common cause of sepsis in infants. Premature infants hospitalized at a neonatal intensive care unit often have risk factors for infection. In this group, the risk of UTI is not clearly known, and guidelines for urine analysis are not unanimous. We aimed to identify the risk of UTI in premature infants with central lines, suspected of late-onset sepsis. We analyzed all 1402 infants admitted to our hospital between 2006 and 2014 with a gestational age less than 32 weeks. Six hundred sixty-two episodes of sepsis evaluations were found with an unknown source of infection based on clinical symptoms. In half of this group, urine analysis was performed identifying UTI in 11.3% (24/212). In 13 of these infants (54%) with a UTI, infection was due to Candida albicans. In at least four episodes, the diagnosis and treatment would have been delayed if urine analysis had not been performed.
CONCLUSION: Based on these findings, we conclude that in premature infants with central lines, urine analysis should be performed routinely when signs of infection occur beyond 72 h after birth. Urine collection should not be delayed and cultures should preferably be performed before the start of the antibiotic treatment. What is known: • In preterm infants, the presence of other risk factors for infection might make clinicians reluctant to obtain urine cultures during sepsis evaluation. • An internal survey demonstrated that there is no consensus within the NICUs in The Netherlands regarding urine analysis as part of LOS work-up. What is new: • The risk of UTI in the NICU population (11.3%) is comparable to term infants; therefore, urine analysis should be performed routinely when LOS is suspected. • Candida albicans was the most frequently (54%) detected pathogen causing UTI in this population.
... hormone balance may be key in the pathogenesis of protein energy wasting in children with chronic kidney disease (CKD... ghrelin and obestatin were measured in 42 children on conservative treatment (CT), 20 children on hemodialysis, 48 pediatricrenal transplant (RTx) recipients and 43 controls (CTR) (mean age 11.9, range 5-20 ...
Kidney Disease (2), Anti-Obesity and Weight Loss (1) Chronic Kidney Diseases (2), more mentions
One third of the surviving infants needed renal replacement therapy during the first 6 weeks of life AbstractText: Over one third of pregnancies with ROH were terminated and the parental decision was based on risk factors associated with adverse outcome. Neonatal death was rare in the actively treated infants and the overall outcome promising.
AbstractText: Inguinal hernias are common in premature infants, but there is substantial variation with regards to timing of ... to quantify and explain this variation AbstractText: Cohort study of infants <34weeks gestation diagnosed with an inguinal hernia and discharged from one of 329 neonatal intensive units between 1998 and 2012 ... variation with regards to the timing of repair of inguinal hernias in premature infants, with an increasing number of infants receiving repair prior to ...