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
Background & objectives: It has been hypothesized that abnormal levels of serum nerve growth factor (NGF) may represent a serological marker for autistic children who may develop cognitive impairment, regression and finally epilepsy. The objective of this preliminary study was to measure serum NGF concentrations of autistic children and compare these levels with those of healthy children. Methods: Consecutive children who were referred to the Paediatric Neurology and Child Psychiatry Policlinics of Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Turkey between February and September 2008 were included in the study. Serum samples were analyzed for NGF levels using ChemiKine NGF Sandwich ELISA Kit. Comparisons between the study and the control groups were made using student’s t test and Chi-square test. Results: Forty-nine autistic children and an equal number of healthy children (control group) were included in the study. No significant difference was found between the study and the control groups in terms of children’s age, while number of boys was significantly higher (P<0.05) in the study group. Average serum NGF concentrations were 46.94 ± 51.40 and 32.94 ± 12.48 pg/ml in the study and control group, respectively. Serum NGF concentrations were significantly higher (P<0.05) in the study group compared with the control group. Interpretation & conclusions: Our preliminary findings show that enhanced serum NGF concentration may be used as a potential diagnostic tool in autism, however, further studies including a large number of patients are required to confirm the findings.