Is there any association between spina bifida occulta and primary vesicoureteral reflux?

Spina bifida occulta [SBO] has been largely considered a benign entity without clinical significance; however, there has been dispute among various authorities, and some believe that the lesion may be linked with various neurologic conditions like urologic dysfunctions. Vesicoureteral reflux [VUR] and lower urinary tract dysfunction are closely related. We examined whether the existence of SBO is related to the prevalence and severity of VUR in children. We investigated 359 children, 2-14 years old, referred to radiology department for obtaining voiding cystourethrogram after the first attack of febrile urinary tract infection. After treatment of infection, with written order of responsible physicians all underwent a standard voiding cystourethrogram to detect VUR and other lower urinary tract anomalies. The patients were divided into two groups: group1 patients who had not SBO and group 2 patients with SBO in postvoiding or KUB films. In each group the presence and severity of VUR was determined in relation to the location of SBO. Out of 359 children 228 [63.5%] had normal spine and 131 [36.5%] had SBO. 54 [23.7%] out of 228 children with normal spine had VUR and 40 [30.5%] out of 131 children with SBO had VUR. The prevalence of VUR in children without SBO and children with SBO was not statistically different. Also we compared the severity of VUR between the two groups and there was no significant difference or trend between presence of SBO and severity of reflux [Chi2 for trend]. VUR was detected in 16.7% children with SBO in L5, 38.3% in L5-S1 and 26.6% in S1. There was no significant relation between location of SBO and prevalence of VUR. Location of SBO and prevalence of VUR are not related

Fungal peritonitis in Iranian children on continuous ambulatory peritoneal dialysis

Fungal peritonitis [FP], causing catheter obstruction, dialysis failure, and peritoneal dysfunction, is a rare but serious complication of peritoneal dialysis. In this study, the frequency and risk factors of FP are evaluated in children who underwent peritoneal dialysis. A retrospective multicenter study was performed at the 5 pediatric peritoneal dialysis centers in Iran from 1971 to 2006, and FP episodes among 93 children were reviewed. Risk ratios were calculated for the clinical and demographic variables to determine the risk factors of FP. Ninety-three children aged 39 months on average were included in study. Sixteen out of 155 episodes of peritonitis were fungi infections, all by Candida albicans. The risk of FP was higher in those with relapsing bacterial peritonitis [P = .009]. Also, all of the patients had received antibiotics within the 1 month prior to the development of FP. Catheters were removed in all patients after 1 to 7 days of developing FP. Six out of 12 patients had catheter obstruction and peritoneal loss after the treatment and 5 died due to infection. Fungal peritonitis, accompanied by high morbidity and mortality in children should be reduced by prevention of bacterial peritonitis. Early removal of catheter after recognition of FP should be considered

Prevalence and symptoms of idiopathic hypercalciuria in primary school children of Tehran

Determining prevalence of idiopathic hypercalciuria [IH] in primary school children of Tehran. We evaluated 778 primary school children [age 6-11, mean 9.1 years] in two steps: first [Screening test], we measured urine calcium to urine creatinine ratio [UCa/UCr] and in the second step [Definitive test], for those children who had UCa/UCr ratio more than 0.21 mg/mg we measured 24 hours urine calcium excretion. Children with secondary forms of hypercalciuria were excluded from the study. Children with idiopathic hypercalciuria were evaluated for manifestations of IH. Among 778 children, 195 [25.1%] had UCa/UCr ratio more than 0.21 mg/mg, but from these 195 children only 128 children delivered 24 hours urine samples. Among these 128 children for whom 24 hours urine calcium measurements were done 28 children excreted more than 4mg/kg/day calcium without hypercalcemia or any other known causes of hypercalciuria and we defined them as having idiopathic hypercalciuria. If all 195 suspicious cases of IH had delivered 24-hrs urine samples we would have 42 cases of IH. Prevalence of IH in our children was 5.4% and its manifestations were: hematuria, dysuria, recurrent abdominal pain, urinary incontinence, urgency, urinary tract infections and urolithiasis