Cuantificación del riesgo de formación de cálculos cálcicos en la orina correspondiente a 2 momentos del día en un grupo de niños estudiados para descartar prelitiasis / Quantification of the risk of urinary calcium stone formation in the urine collected at 2 times of the day in a group of children studied to rule out prelithiasis

ANTECEDENTES: En la urolitiasis inte:rvienen diversos factores genéticos y ambientales. Las 2 anomalías metabólicas más frecuentes son el incremento en la eliminación urinaria de calcio y la reducción en la de citrato. El cociente calculado entre las concentraciones de ambas sustancias es un buen marcador de riesgo de formación de cálculos cálcicos. OBJETIVOS: Determinar si el riesgo litógeno en la orina de un mismo paciente cambia a lo largo del día. MÉTODOS: Se estudiaron 56 niños (23 V, 33 M) para comprobar si eran portadores de prelitiasis. Se determinaron las concentraciones de calcio, citrato y creatinina en 2 muestras de orina recogidas, una, antes de cenar, y la otra, por la mañana, al levantarse. Se anotó si tenían cálculos ecográficos y si existían antecedentes de urolitiasis en los familiares de primer y/o segundo grado. RESULTADOS: En 25 pacientes (44,6%) la ecografía renal fue positiva para litiasis (cálculos [n = 9] y microcálculos [n = 16]). En 40 de las 56 familias (71,4%) existían antecedentes de urolitiasis. El porcentaje mayor de valores anormales de la concentración urinaria de calcio (28,6%) y del cociente calcio/citrato (69,6%) correspondió a la primera orina del día. Este último parámetro fue el único entre los estudiados que se relacionó con los antecedentes familiares de urolitiasis. No se comprobaron diferencias en los parámetros urinarios al comparar a los pacientes con presencia o ausencia de litiasis renal ecográfica. CONCLUSIONES: Las concentraciones urinarias de calcio y del cociente calcio/citrato se modifican a lo largo del día. Las orinas formadas durante la noche son más litógenas

BACKGROUND: Various genetic and environmental factors are involved in urolithiasis. The 2 most common metabolic abnormalities are the increase in urinary calcium and low urinary citrate excretion. The ratio calculated between the concentrations of both substances is a good risk marker for the formation of calcium stones. OBJECTIVES: To determine whether the risk of urinary calcium stone formation changes throughout the day in the same patient. METHODS: We studied 56 children (23 V, 33 M) to check if they had prelithiasis. Calcium, citrate, and creatinine concentrations were determined in two urine samples collected one before dinner and the other in the morning. It was collected if they had ultrasound stones and if there was a history of urolithiasis in first and/or second degree relatives. RESULTS: In 25 patients (44.6%), renal ultrasound was positive for lithiasis (stones [n = 9] and microlithiasis [n = 16]). Forty of the 56 families (71.4%) had a history of urolithiasis. The percentage of abnormal urinary calcium (28.6%) concentrations and an abnormal calcium/citrate ratio (69.6%) was higher in the first urine of the day. The calcium/citrate ratio was the only studied parameter that was related to a family history of urolithiasis. There were no differences in urinary parameters between patients with and without ultrasound-confirmed kidney stones. CONCLUSIONS: Urinary concentrations of calcium and the calcium/citrate ratio vary throughout the day. Urine produced at night has a higher risk of urinary calcium stone formation

Quantification of the risk of urinary calcium stone formation in the urine collected at 2 times of the day in a group of children studied to rule out prelithiasis. / Cuantificación del riesgo de formación de cálculos cálcicos en la orina correspondiente a 2 momentos del día en un grupo de niños estudiados para descartar prelitiasis.

BACKGROUND: Various genetic and environmental factors are involved in urolithiasis. The 2 most common metabolic abnormalities are the increase in urinary calcium and low urinary citrate excretion. The ratio calculated between the concentrations of both substances is a good risk marker for the formation of calcium stones. OBJECTIVES: To determine whether the risk of urinary calcium stone formation changes throughout the day in the same patient. METHODS: We studied 56 children (23V, 33M) to check if they had prelithiasis. Calcium, citrate, and creatinine concentrations were determined in two urine samples collected one before dinner and the other in the morning. It was collected if they had ultrasound stones and if there was a history of urolithiasis in first and/or second degree relatives. RESULTS: In 25 patients (44.6%), renal ultrasound was positive for lithiasis (stones [n=9] and microlithiasis [n=16]). Forty of the 56 families (71.4%) had a history of urolithiasis. The percentage of abnormal urinary calcium (28.6%) concentrations and an abnormal calcium/citrate ratio (69.6%) was higher in the first urine of the day. The calcium/citrate ratio was the only studied parameter that was related to a family history of urolithiasis. There were no differences in urinary parameters between patients with and without ultrasound-confirmed kidney stones. CONCLUSIONS: Urinary concentrations of calcium and the calcium/citrate ratio vary throughout the day. Urine produced at night has a higher risk of urinary calcium stone formation.

Estimación del daño por trauma ocular en Pediatría sin la evaluación de la agudeza visual / Estimation of damage in pediatric ocular trauma without evaluating visual acuity

Introducción. La cuantificación de la agudeza visual (AV) en el niño con trauma ocular puede ser limitada. El objetivo de este estudio fue estimar si los parámetros del sistema de clasificación de lesiones mecánicas oculares (SCLMO) podrían detectar la afección visual significativa (AVS) y el daño del segmento posterior (DSP), sin evaluar la AV. Métodos. Se realizó un estudio observacional, analítico, transversal, retrospectivo y abierto. Se incluyeron niños con trauma ocular y calificación del SCLMO. Se identificaron los ojos con AVS y DSP y se compararon sus proporciones entre los parámetros del SCLMO (χ², razón de momios RM). Resultados. Se analizaron doscientos ojos de pacientes con edad promedio de 10.88 años. Los parámetros asociados con AVS fueron: globo abierto con trauma abierto tipo A (p =0.002, RM=14.14), globo con trauma abierto (p <0.001, RM=11.25), zona II (p =0.001, RM=3.17) y pupila positiva (p <0.001); los asociados con DSP: zona III (46.5%, p <0.001, RM=26.43) y globo con trauma abierto tipo A (40.0%, p=0.059, RM=3.39). Conclusiones. La AVS podría detectarse sin medir la AV en pacientes pediátricos siempre que se evalúen los parámetros restantes del SCLMO.

Background. Quantifying visual acuity (VA) can be limited in children with ocular trauma. Could the parameters of the system for classifying mechanical injuries of the eye (SCMIE) detect the eyes with significant visual affection (SVA) and damage in the posterior ocular segment (DPOS) without the need for visual acuity evaluation? Methods. An observational, analytical, cross-sectional, retrospective and open label study was conducted. Pediatric patients with uni- or bilateral eye trauma and grading using the SCMIE were evaluated. We identified eyes with SVA and those with DPOS. Their rates were then compared between the parameters of SCMIE (χ2 and odds ratio, OR). Results. Two hundred eyes were evaluated (mean age: 10.88 years). The parameters associated clinically with SVA were type A open globe (p = 0.002, OR = 14.14), open globe (p <0.001, OR = 11.25), zone II (p = 0.001, OR = 3.17) and positive pupil (p <0.001). Those associated with DPOS were zone III (46.5%, p <0.001, OR = 26.43) and type A open globe (40.0%, p = 0.059, OR = 3.39). Conclusions. Ocular trauma that causes SVA in children may be detected without measuring VA, provided that the remaining parameters of the SCMIE are evaluated.