RESUMEN
Posterior urethral valves [PUV] are the most common cause of bladder outlet obstruction in infancy that impair renal and bladder function. This study was planned to evaluate and record the various clinical presentations and management, complications, and surgical management and long-term outcome of PUV. In a retrospective study, 98 patients who have been treated for PUV are evaluated in Mofid Children's Hospital from January 2007 to December 2012. Detailed history taken and paraclinical examinations were performed in each patient and diagnosis was confirmed by voiding-cysto-urethrography [VCUG]. PUV had been ablated in 62 patients by electric hook, and diversion was performed in 42 [42.85%] cases. Data were analyzed by SPSS software versionlS. Totally 98 patients with mean age at diagnosis 62 [ +/- 13] days were included in this study. Fifty seven cases had been catheterized within one to 6 days of life [mean age one day], PUV was ablated in 62 patients by electric hook, and dive rsion was performed in 42 cases. The most common symptom in our group was dribbling poor stream 51% and urinary tract infection [UT1] 40.8%. There was vesicoureteral-reflux [VUR] in 61.2%, and hydronephrosis in 82.6%. Most common associated anomaly was kidney anomalies [multicystic kidney disease and renal agenesis/dysplasia] in 8 [8.2%] patients. Twenty patients had prenatal diagnosis of PUV. Complication occurred in three [3.1%] patients. Mortality occurred in 5 [5.1%] patients. Mean follow-up period was 3.4 +/- 1.2 years [1.5 months to 5 years]. Urinary drainage by feeding tube in early days of infancy, followed by valve ablation is the best treatment in PUV, and urinary diversion improves the outcome. VCUG is still the gold-standard imaging modality for documenting PUVs. The factors like renal dysplasia and UTI have their role in final outcome
RESUMEN
Patients in the intensive care unit [ICU] are susceptible to develop electrolyte imbalance resulting in increased mortality rate. Electrolyte measurements especially for sodium and potassium are frequently required in critically ill patients. The purpose of the present study was to compare sodium and potassium concentrations between serum from venous blood and plasma from arterial blood in order to decrease the number of needle punctures required in children admitted to the ICU. Thirty-five patients admitted to the pediatric intensive care unit [PICU] were enrolled in this study; hypotensive patients were excluded. Two cc venous and 1cc arterial blood samples were taken for serum and plasma measurement of sodium and potassium. Venous samples were analyzed within 15 minutes in the hospital laboratory and arterial samples were immediately auto-analyzed in the PICU for sodium and potassium concentrations. Mean serum concentrations of sodium [NaV=137.1 +/- 5.5] and potassium [KV=4.1 +/- 0.7] were higher than plasma concentrations of sodium [NaA=133.1 +/- 11.1] and potassium [KV =3.1 +/- 0.7]; [p<0.02 and p<0.001 respectively]. Linear regression showed NaV= 106+0.23 Na A for sodium; [p=0.005], and KV= 1.96+0.69 KA; [p<0.001] for potassium. Serum concentrations of sodium and potassium were higher than their plasma levels and could be calculated using the plasma sample and the formula given above