Serum levels of interleukin-6 and interleukin-8 as diagnostic markers of acute pyelonephritis in children / 소아과

PURPOSE: Early diagnosis and treatment of acute pyelonephritis in children is of special importance in order to prevent serious complications. This study was conducted to determine the diagnostic value of serum interleukin (IL)-6 and IL-8 in children with acute pyelonephritis. METHODS: Eighty-seven patients between 1 month to 12 years old with urinary tract infection (UTI) were divided into 2 groups based on the result of 99m-technetium dimercapto-succinic acid renal scan: acute pyelonephritis (n=37) and lower UTI (n=50) groups. White blood cell (WBC) count, neutrophil (Neutl) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, platelet count, and serum IL-6 and IL-8 concentrations of both groups were measured and compared. RESULTS: There was a significant difference between two groups regarding WBC count, Neutl count, ESR, and CRP concentration (P<0.05). In addition, the difference between the two groups regarding serum IL-6 and IL-8 concentrations was not significant (IL-6, 60 and 35.4 pg/mL and IL-8, 404 and 617 pg/mL, respectively). The sensitivity and specificity of serum IL-6 and IL-8 for diagnosis of acute pyelonephritis were 73%, 42% and 78%, 32%, respectively. Sensitivity, specificity, negative and positive predictive values of serum IL-6 and IL-8 were less than those of acute phase serum reactants such as CRP. CONCLUSION: This study showed that there was no significant difference between acute pyelonephritis and lower UTI groups regarding serum IL-6 and IL-8 levels. Therefore, despite confirming results of previous studies, it seems that IL-6 and IL-8 are not suitable markers for differentiating between acute pyelonephritis and lower UTI.

Comparison of procalcitonin and C-reactive protein tests in children with urinary tract infection

Urinary tracet infection [UTI] is a common discase in children. The distinction between upper and lower UTI in children is associated with some ambiguities. The objective of this study was to determine the sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] of procalcitonin [PCT] compared to C-reactive protein [CRP] in predicting renal involvement. Serum concentrations of PCT and CRP in blood samples of 111 children with UTI were measured. Renal parenchymal involvement was evaluated with 99mTc-dimercaptosuccinic acid [DMSA] scintigraphy. Sensitivity, specificity, PPV and NPV were determined. Out of 111 children, 52 [46.8%] were shown to have acute renal involvement, 23 [20.7%] lower UTI, and 36 [32.5%] refused to be examined by DMSA renal scan. PCT was positive in 36 [69.2%] patients with upper UTI and 12 [52.2%] with lower UTI. The sensitivity, specificity, PPV and NPV obtained for PCT and CRP were 70.6, 45.5, 75, 40% and 96.2, 4.3, 69.4,; and 33.3%, respectively. No significant correlation was found between renal parenchymal involvement and serum levels of PCT and CRP. However, the results demonstrated that the PCT was a better diagnostic test compared to CRP

Effect of a PRECEDE-based educational intervention on depression and quality of life in patients with coronary artery bypass grafting

To examine effect of an educational intervention on depression and quality of life in patients with coronary artery bypass grafting surgery. This was a quasi-experimental study of 54 patients after bypass surgery in the Isfahan Cardiovascular Research Center. The patients randomly assigned to intervention and control groups. Primarily Cardiac Depression Scale was used to measure depression. In addition, a PRCEDE-based educational questionnaire and the end SF-36 questionnaire were used. The intervention group received a PRCEDE Model educational package up four months. After education the mean score of Predisposing factors, Enabling factors, Reinforcing factors and self-helping behaviors increased significantly in the intervention group as compared to the control group [P < 0.001]. The mean score of depression in control group [M = 104/5, SD = 30/4] and intervention group [M = 112/8, SD = 21/9] decreased significantly, but this effect was more pronounced in intervention group [M = 66/2, SD = 22 vs M = 89/2, SD = 27/8]. Also the significant differences in quality of life between two groups were seen in physical functioning [P < 0.04], role emotional [P < 0.01] and mental component summary [P < 0.04]. The findings of this study indicated that the PRCEDE Model was effective educational intervention in reducing depression and enhancing quality of life in patients with coronary artery bypass surgery