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1.
Nephron ; 90(1): 8-15, 2002 Jan.
Article in English | MEDLINE | ID: mdl-11744799

ABSTRACT

The purpose of the study was to investigate the management of pyelonephritis in a large Italian pediatric population. A total of 1,333 patients (36% male) were considered. Escherichia coli was the most frequently isolated agent (89.9%), followed by Proteus mirabilis (3.6%) and Klebsiella oxytoca (2.1%). 27% of microorganisms were resistant to amoxicillin, 4% to amoxicillin/clavulanic acid, 11% to trimethoprim-sulfamethoxazole, 2.4% to gentamicin and less than 2% to ceftazidime. Despite this resistance pattern showing that oral antibiotics, such as amoxicillin/clavulanic acid, are effective in vitro as well as parenteral antimicrobials, a parenteral antibiotic was given initially to 756 (57.2%) children. A prophylactic regimen was started in 922 patients with a rate of reinfection during prophylaxis of 9.5%; a higher rate of reinfection was observed in patients with reflux (25%) compared to children without reflux (3%) (p < 0.0001). Vesicoureteral reflux was demonstrated in 30% of patients. The number of renal abnormalities detected by DMSA in patients with and without reflux was significantly different (p < 0.001). CRP was higher in patients with scars (p < 0.02). In conclusion, pyelonephritis represents a common disease with about 2,500 days of hospitalization per year in the Veneto Region where there is a pediatric population of about 800,000 under 15 years of age. The results of antimicrobial in vitro tests indicate that amoxillicin/clavulanic acid could represent the antibiotic of choice. The high frequency of malformations, observed even in children between 6 and 12 years of age, may suggest the need of an imaging study including DMSA scan and VCUG in all age groups.


Subject(s)
Anti-Bacterial Agents/therapeutic use , Pyelonephritis , Acute Disease , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Kidney/diagnostic imaging , Kidney/microbiology , Male , Pyelonephritis/diagnosis , Pyelonephritis/drug therapy , Pyelonephritis/microbiology , Radionuclide Imaging , Retrospective Studies , Ultrasonography , Urine/microbiology
2.
J Chromatogr B Biomed Appl ; 672(1): 155-9, 1995 Oct 06.
Article in English | MEDLINE | ID: mdl-8590929

ABSTRACT

We report a new HPLC procedure for measuring inulin in plasma and urine. Samples after dilution are boiled in mild acidic conditions and then analyzed on a C18 column. Solvent system A is 3.2 mM HCl, pH 2.5, and B is acetonitrile-3.2 mM HCl (60:40, v/v), pH 2.5. The separation is carried out in 8 min with a flow-rate of 1.0 ml/min and the absorbance monitored at 280 nm. The relationship between inulin and the recorded peak area is linear from 0.2 to 3.2 mg/ml with a correlation coefficient of 0.999 for plasma and 0.999 for urine. Within-run precision, measured at three inulin concentrations, ranged from 0.9 to 1.7% in plasma and from 0.8 to 1.2% in urine. Between-run precision varied in plasma from 2.7 to 3.2% and in urine from 3.0 to 3.3%. Analytical recovery ranged from 102 to 107% in plasma and from 101 to 105% in urine, respectively. The method is sensitive, selective and only 30-microliters samples are required. Therefore, it could be used to evaluate the glomerular filtration rate even in small babies and to perform studies in animals.


Subject(s)
Chromatography, High Pressure Liquid/methods , Inulin/analysis , Adult , Child , Child, Preschool , Glomerular Filtration Rate , Humans , Hydrolysis , Inulin/blood , Inulin/urine , Kidney Diseases/blood , Kidney Diseases/urine , Reproducibility of Results , Spectrophotometry, Ultraviolet
3.
J Chromatogr ; 574(1): 156-60, 1992 Feb 07.
Article in English | MEDLINE | ID: mdl-1629281

ABSTRACT

A sensitive and accurate assay was developed for the measurement of 8-methoxypsoralen in plasma using electron-impact positive-ion mass fragmentography. 4,5,8-Trimethylpsoralen was used as an internal standard. Sample preparation consisted of a two-step liquid phase extraction using acetonitrile and methylene chloride. The calibration curve showed a linear relationship between the peak areas of 8-methoxypsoralen and 4,5,8-trimethylpsoralen over a wide range of 8-methoxypsoralen concentrations (1-500 ng/ml). With-in- and between-run precisions, measured at five different drug concentrations, varied from 0.82 to 1.41% and from 0.82 to 1.86%, respectively.


Subject(s)
Methoxsalen/metabolism , Gas Chromatography-Mass Spectrometry , Humans , Ions , Methoxsalen/therapeutic use , Photochemotherapy
4.
J Chromatogr ; 497: 101-7, 1989 Dec 29.
Article in English | MEDLINE | ID: mdl-2625447

ABSTRACT

A new reversed-phase high-performance liquid chromatographic procedure for the determination of urinary orotate excretion is described. It is a selective, sensitive and rapid method, suitable for the differentiation of inherited metabolic diseases with abnormal orotate metabolism.


Subject(s)
Orotic Acid/urine , Chromatography, High Pressure Liquid , Gas Chromatography-Mass Spectrometry , Humans , Orotic Acid/isolation & purification
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