Are Clinical, Laboratory, and Imaging Markers Suitable Predictors of Vesicoureteral Reflux in Children With Their First Febrile Urinary Tract Infection?

PURPOSE: This study was conducted to determine the predictive value of clinical, laboratory, and imaging variables for the diagnosis of vesicoureteral reflux in children with their first febrile urinary tract infection. MATERIALS AND METHODS: One hundred fifty-three children with their first febrile urinary tract infection were divided into two groups according to the results of voiding cystourethrography: 60 children with vesicoureteral reflux and 93 children without. The sensitivity, specificity, positive and negative predictive value, likelihood ratio (positive and negative), and accuracy of the clinical, laboratory, and imaging variables for the diagnosis of vesicoureteral reflux were determined. RESULTS: Of the 153 children with febrile urinary tract infection, 60 patients (39.2%) had vesicoureteral reflux. There were significant differences between the two groups regarding fever>38degrees C, suprapubic pain, C-reactive protein quantitative level, number of red blood cells in the urine, and results of renal ultrasound and dimercaptosuccinic acid renal scanning (p38.2degrees C and dimercaptosuccinic acid renal scanning and vesicoureteral reflux. Also, there were significant positive correlations between the erythrocyte sedimentation rate, positive urinary nitrite test, hyaline cast, and renal ultrasound and high-grade vesicoureteral reflux. CONCLUSIONS: This study revealed fever>38.2degrees C and dimercaptosuccinic acid renal scanning as the best predictive markers for vesicoureteral reflux in children with their first febrile urinary tract infection. In addition, erythrocyte sedimentation rate, positive urinary nitrite test, hyaline cast, and renal ultrasound are the best predictive markers for high-grade vesicoureteral reflux.

Serum interleukin-1beta and tumor necrosis factor-alpha in febrile seizures: is there a link? / 소아과

PURPOSE: Febrile seizures are induced by fever and are the most common type of seizures in children. Although numerous studies have been performed on febrile seizures, their pathophysiology remains unclear. Recent studies have shown that cytokines may play a role in the pathogenesis of febrile seizures. The present study was conducted to identify potential links between serum interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha), and febrile seizures. METHODS: Ninety-two patients with simple or complex febrile seizures (46 patients per seizure type), and 46 controls with comparable age, sex, and severity of temperature were enrolled. RESULTS: The median concentrations of serum IL-1beta in the simple, complex febrile seizure, and control groups were 0.05, 0.1, and 0.67 pg/mL, respectively (P=0.001). Moreover, the median concentrations of TNF-alpha in the simple, complex febrile seizure, and control groups were 2.5, 1, and 61.5 pg/mL, respectively (P=0.001). Furthermore, there were significant differences between the case groups in serum IL-1beta and TNF-alpha levels (P<0.05). CONCLUSION: Unlike previous studies, our study does not support the hypothesis that increased IL-1beta and TNF-alpha production is involved in the pathogenesis of febrile seizures.

effect of clofibrate on hyperbilirubinemia of term neonates

Clofibrate is a glucuronosyl transferase inducer that has been proposed to increase the elimination of bilirubin in neonates with hyperbilirubinemia. This study was conducted to determine the therapeutic effect of clofibrate in term neonates with non-hemolytic jaundice. This study was conducted on 52 newborns with pathologic unconjugated jaundice in Qazvin children hospital. Newborns divided randomly in two groups. Case group treated with clofibrate and intensive phototherapy, while control group treated only with intensive phototherapy. Serum bilirubin level was measured before and 6, 12, 24 and 48 hours after treatment. Results were compared and analyzed. The mean serum level of bilirubin before treatment in the case and control groups were 20.78 +/- 2.38 and 20.52 +/- 2.44 mg/dl, respectively [P=0.69]. The mean serum level of bilirubin in 6, 12, 24 and 48 hours after treatment in the case group were 18.20 +/- 2.20, 14.70 +/- 2.06, 10.72 +/- 2.40 and 8.90 +/- 0.83 mg/dl, respectively. These values in control group were 18.26 +/- 2.42, 15.36 +/- 2.59, 12.29 +/- 2.28 and 10.23 +/- 1.50 mg/dl, respectively. There was significant difference between two groups regarding mean serum level of bilirubin 24 hours [P=0.019] and 48 hours after treatment [P=0.005]. In conclusion, clofibrate was effective in reducing neonatal jaundice and its effect appeared 24 hours after treatment