RESUMEN
Hemorrhagic Cystitis [HC] is an infectious or noninfectious process that leads to gross hematuria originating from the urinary bladder mucosa. A previously healthy 2.5-year-old boy was referred to our center five hours after ingestion of 120 ml [6 g] of cephalexin suspension with abdominal pain, diarrhea, vomiting, and gross hematuria. The results of the general physical examination were unremarkable except for mild suprapubic tenderness. He was admitted to the hospital and hydrated. Laboratory tests on admission showed normal CBC and electrolytes, normal PT and PTT, negative coombs test, many RBCs per high-power field [HPF] in the urine, and normal urinary tract sonography. Within 24 hours, the urine cleared, showing only 1 to 2 red blood cells per high power field with no changes in the CBC, electrolytes, or kidney function tests. His urine culture was negative. Although there are reports of antibiotic- induced HC, the rarity of cephalosporins and cephalexin induced hemorrhagic cystitis encouraged us to report this observation
RESUMEN
Brucellosis is a world-wide disease, which has a diverse clinical manifestation, and its diagnosis has to be proven by laboratory data. Serum agglutination test [SAT] is the most-widely used test for diagnosing brucellosis. The enzyme linked immunosorbent assay [ELISA] can also determine specific antibody classes against brucella. It is a sensitive, simple and rapid test, which could be an acceptable alternative to SAT with fewer limitations, however, like any other new test it should be further evaluated and standardized for various populations. This study was planned to determine an optimal cut-off point, for ELISA which would offer maximum sensitivity and specificity for the test when compared to SAT. Four hundred and seven patients with fever and other compatible symptoms of brucellosis were enrolled in the study. Serum agglutination test, 2-Mercaptoethanol test, and ELISA were performed on their sera. The cut-off point of 53 IU/ml of ELISA-IgG yielded the maximal sensitivity and specificity comparing to the other levels of ELISA-IgG, and was considered the best cut offpoint of ELISA-IgG to diagnose acute brucellosis. At this cutoff, the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were 84.09%, 85.38%, 62.20, 94.90, 5.75, 0.18, respectively. The best cut-off point of ELISA-IgG is 53 IU/ml, which yields the maximal sensitivity and specificity to diagnose acute brucellosis
RESUMEN
Prader-Willi Syndrome [PWS] is a genetic syndrome presenting with severe hypotonia and decreased agility. Growth Hormone [GH], which is often used in these patients to treat short stature and obesity, seems improve hypotonia, physical strength, activity, and locomotor developmental ability. The aim of this study was to find the effects of growth hormone on agility and strength of these patients. In a prospective randomized controlled clinical trial in an out-patient pediatric endocrine clinic in Tehran, 21 PWS children [12 boys and 9 girls, 4 to 9 years old] were divided into either GH-treated or control groups and followed for two years. Agility run, sit ups, weight lifting, and inspiratory and expiratory strength were considered as the main outcome measures. All the outcome measures of the GH treated group showed a significant improvement compared to the control group. GH causes a significant improvement in agility and strength of PWS children
RESUMEN
Recently obesity in pediatric population is rising fast and its early onset complications [like those seen in adults] are keeping pace with it. It seems that a high level of urinary uric acid [UUA] could be the result of reproduction of uric acid in the body. On the other hand, it was shown to be the result of decreased urinary clearance of uric acid in some obese adults. Target of study is the mechanism of hyperuricemia in obese children and also the correlation between hyperuricemia and factors related to the obesity. We studied 75 severely obese children [42 boys and 33 girls] and compared them with 30 non-obese children [20 boys and 10 girls]. Serum leptin, lipid profile, liver tranaminases, uric acid and creatinine and also 24 hours urinary uric acid and creatinine were measured, and uric acid clearance was calculated in each case. Serum uric acid level [U.A] in obese children were significantly higher than those in control children, but urinary uric acid [UUA], uric acid clearance [CUA] and fractional excretion of uric acid [FEUA = CUA/CCR * 100] were lower in the obese children than those in controls. The low UUA in the obese children suggests that their hyperuricemia was not the result of over intake of food containing uric acid. There was a close correlation between uric acid and age/body weight and it becomes closer as they aged and gained weight. These results suggest that hyperuricemia in obese children is mainly attributable to impaired renal clearance of uric acid and not to overproduction in the body and it will higher age and body weight