ABSTRACT
Objective: Urinary tract infections (UTIs) are common in children and may signal vesicoureteral reflux (VUR). This study aimed to identify the risk factors associated with VUR and to emphasize value of diagnostic imaging studies in children. Methods: This study was assessed 173 medical records of children who had first-time UTI in Ege University Pediatric Nephrology Department between January 2008 and January 2010. Patients were divided into 2 groups according to localization of UTI infections. Patients with fever, elevated acute phase reactants, low urine osmolarity and positive urinary culture were defined as having an upper UTI (Group I). Patients without systemic symptoms were defined as having a lower UTI (Group II). Results: Ultrasonography (US) findings were abnormal in 43.4% patients. Abnormal dimercaptosuccinic acid (DMSA) was detected in 45% of patients and VUR was found in 41%. US had 52.4% sensitivity and 64.4% specificity for cortical defects in DMSA, and 52.4% sensitivity and 46.4% specificity for VUR. In Group I, DMSA had 70% sensitivity and 70% specificity for reflux in voiding cystourethrography. In Group II, US had 53% sensitivity and 48% specificity for cortical defects in DMSA, and 50% sensitivity and 41% specificity for VUR. DMSA had 62.5% sensitivity and 54.5% specificity for VUR. Conclusions: Patients with UTIs should not be evaluated according to age and localization, only but rather according to all risk factors.
ABSTRACT
Hypertension may lead to irreversible damages in vital organs, such as heart, brain, and kidney, and may cause death in children if treatments are not given despite early diagnosis. This cross-sectional epidemiological study was conducted during 1 January-31 March 2004 to investigate the prevalence of hypertension among high school students. The study cohort included 1,041 students of six high schools, who were selected from among 14,789 students of 26 high schools in Sivas province of Turkey, using the cluster-sampling method. A questionnaire was used for collecting information from students on age, gender, smoking, and whether they or their families have any diseases. Blood pressure, height, and weight of the participitants were determined by the research group. Students whose repeated systolic or diastolic blood pressures were higher than the 95th percentile were considered to be hypertensive patients. Hypertension was prevalent among 4.4% (n=45) of the students. There was a significant correlation between prevalence of hypertension and body mass index. No significant correlation was found between prevalence of hypertension and other variables, such as smoking, age, gender, and family history of diabetes. The results suggest that hypertension is an important public-health problem among high school students. The results also showed that the body mass index was an important parameter in hypertension in such a study group. Researchers should consider overweight a causative risk factor for development of hypertension in early-onset groups.