Infecciones del tracto urinario en neonatos sin explicación. Hiperbilirrubinemia: Prevalencia y predictivo factores de riesgo / Urinary tract infections in unexplained neonatal hyperbilirubinemia: Prevalence and predictive risk factors

Introduction: Urinary tract infections (UTIs) are widespread clinical disorder among early neonates. Neonates with UTIs were susceptible to higher rates of morbidity and mortality, particularly when presented with hyperbilirubinemia. Early diagnosis may help in complete recoveryrather than being threatened in terms of complications. The study aimed at determining the prevalence and predictive risk factors of UTIs in neonates with an unexplained hyperbilirubinemia. Method: A cross-sectional study was carried out in the NICU of Aswan University Hospital, Egypt from August 2018 to February 2019. The study was conducted on 140 newborns who were diagnosed with indirect hyperbilirubinemia in the first 4 weeks of life after exclusion of unrelated criteria. Demographic and clinical data were collected by an interview questionnaire. Biochemical markers including bilirubin level, CBC, urine analysis and urine cultures and sensitivity were determined. Results: The prevalence rate of UTIs in the studied newborns was 25%. Escherichia -coli was the dominant organism isolated. Amikacin was the most common antibiotic sensitive to the isolates. There was a significant difference between the UTI positive and negative neonates in the univariate analysis regarding some studied variables. While, an increase in the number of WBCs in the blood (OR = 6.90, P = 0.001), small for gestational age (OR = 4.07, P = 0.021), prolonged phototherapy (OR = 3.50, P = 0.034), and presence of maternal complications (OR = 2.92, P = 0.001) were statistically associated with a positive urine culture in multivariate analysis. Conclusions and recommendations: The prevalence rate of UTIs was 25%. The study indicated the importance of routine screening of UTI (urine culture) as part of the clinical assessment of unexplained hyperbilirubinemia in neonates with an increase in the number of WBCs in their blood, small for gestational age, prolonged duration of phototherapy, and neonates born from mothers who had a history of obstetric complications

Evaluation of high sensitivity C-reactive protein and Von Willebrand factor in patients with myocardial infarction

Many patients who present with acute coronary syndromes have no apparent clinical risk factors. This finding points out the need for markers that better predict cardiovascular risk. Evaluation of high sensitivity C-reactive protein [hs-CRP] serum levels as well as some other inflammatory markers such as von Willebrand factor [vWF] and erythrocyte sedimentation rate [ESR] in patients with acute myocardial infarction [AMI]. This study was performed on twenty five patients with AMI [21 males and 4 females], and twenty five apparently healthy persons as a reference group [20 males and 5 females]. Patients were subdivided into two groups: Group I: included ten patients presenting more than 6 hours after the onset of symptoms.Group II: included fifteen patients presenting within the first 6 hours after the onset of symptoms. Clinical examination and the following laboratory investigations were done: [A] Routine investigations: blood picture, serum glucose, kidney function tests, prothrombin time and concentration, liver function tests, lipogram, ESR, creatine phosphokinase [CPK] and lactate dehydrogenase [LDH] [B] Special Investigations: hg-CRP, vWF-Ag, and Troponin I. LDH, CPK as well as both ESR-1st h and 2nd h values showed elevations in both patient groups compared to controls [p<0.001], but there was no significant difference between the two patient groups: CRP values showed significant elevation in both patients groups compared to controls [p<0.001], and the elevation was significantly pronounced in group I compared to group II [p<0. 001]. Both plasma vWF-Ag and serum Troponin I values showed significant increase in both patient groups compared to controls [p<0.001], but there was no significant difference between the two groups. Significant positive correlations between vWF and CPK [r=0.646, P < 0.001] and between vWF and LDH [r = 0.507, P < 0.01] were found in AMI patients. Both hs-CRP and vWF are significantly high in patients with AMI. Thus, they can be considered as valuable markers of AMI that can aid in the diagnosis of AMI. Consistent and significant elevation of hs-CRP within the first 6 hours in patients developing myocardial infarction, which is attributed to chronic inflammatory atherosclerotic process rather than myocardial damage, suggest that hs-CRP has a potential predictive value for MI

Autoreactive lymphocytotoxic antibodies in sensitised ureamic patients

We have studied 60 end stage renal disease patients, their age ranged between 2040 years. The sera of these patients were screened for the presence of lymphocytotoxic antidodies against peripheral blood lymphocytes of a random cell panel. Lymohocytotoxic antibodies were demonstrated in 25 patients [40%]. Those patient, with positive lymphocytotoxic antibodies were divided into groups. Those who undergoing maintenance heamodialysis and have recieved several blood transfusion [Group A].Those who have diagnosed for the first time and have not recieved blood [Group B]. The serum of those patients which were reactive with 30-100% of the above cell panel were then tested against autologous peripheral blood lymphocytes for detection of autoreactive lymphocytotoxic antibodies [AlcAs]. Autoreactive antibodies were detected in 50% of patients of group A and 18.8% of group B