Determinants of bone mineral density, bone mineral content, and body composition in a cohort of healthy children: influence of sex, age, puberty, and physical activity.

Interventions directed to the recognition of abnormal bone mineral density, bone mineral content, and body composition in the pediatric age require the definition of factors influencing bone mass acquisition during growth. We have evaluated in a cross-sectional manner by dual-energy X-ray absorptiometry the impact of sex, age, puberty, and physical activity on total body areal bone mineral density, regional (lumbar and femoral) bone mineral densities, bone mineral content, and body composition (fat mass and lean mass) in a cohort of 359 healthy Italian children aged 3-14 years and investigated their specific contribution to bone mass accrual. Statistical multiple regression analysis was performed dividing the population in pre- and post-pubertal groups.

Relationship between the clinical-neurophysiologic pattern, disability, and quality of life in adolescents with spina bifida.

A number of studies have focused on quality of life in children with spina bifida, concentrating for the most part on younger children. We assessed health-related quality of life and disability in adolescents with spina bifida and correlated these with the clinical and neurophysiologic picture. Twelve consecutive spina bifida cases were evaluated through a multiperspective protocol by means of (1) clinical and neurophysiologic assessment, (2) a self-administered questionnaire for general health--Short Form-36 (SF-36)--and (3) standardized disability measurements (Functional Independence Measure, Barthel Index, Deambulation Index).

Risk factors for poor renal prognosis in children with hemolytic uremic syndrome.

Many factors have been proposed as predictors of poor renal prognosis in children with hemolytic uremic syndrome (HUS), but their role is still controversial. Our aim was to detect the most reliable early predictors of poor renal prognosis to promptly identify children at major risk of bad outcome who could eventually benefit from early specific treatments, such as plasmapheresis. Prognostic factors identifiable at onset of HUS were evaluated by survival analysis and a proportional hazard model.

Amoxicillin-induced nephritis and tubulitis in a child.

The occurrence of interstitial nephritis in patients receiving antimicrobial therapy has frequently been reported in adults while it has rarely been described in children. We report the case of a patient treated with amoxicillin who presented hallucinations and serosanguineous blisters during treatment and developed renal failure a few days after discontinuation of the drug. On renal biopsy an interstitial nephritis with tubulitis was identified.

Neurogenic bladder dysfunction: urodynamic evaluation.

The main goal in the management of children with neurogenic bladder is to preserve renal function and assure a socially acceptable continence. Urodynamic testing based on cystomanometry evaluation of intravesical pressure and flow measurement, at present is considered the examination of first choice in the diagnosis of neurogenic micturition disorders to better classify the type of bladder based on the risk of upper urinary tract impairment and be able to plan a specific, personalized management.

Clinical patterns of neurogenic bladder.

The neurogenic bladder represents a vesical dysfunction secondary to a congenital or acquired neurologic lesion, spinal dysraphism being the most common cause in pediatric age. According to the lesion level and severity, neurogenic bladder can be hypertonic hyperreflexic, hypotonic hyporeflexic or of mixed type characterized by different clinical and urodynamic patterns and the potential cause of nephrourologic complications. These types of neurogenic bladder require diversified treatments as anticholinergic drugs, clean intermittent catheterization and antibiotic prophylaxis, separately or in various combinations.

Health-related quality of life and disability in young patients with spina bifida.

Objectives: To assess the health-related quality of life (QOL) and disability in young patients with spina bifida and to correlate them with the clinical examination findings.

Design: Prospective multidimensional study by means of (1) clinical assessment, (2) self-administered questionnaire for general health, and (3) standardized disability measurements. Relationships between disability measurement, patient-oriented examination, and conventional clinical assessment were evaluated.

Plasma antidiuretic hormone levels in children with spina bifida.

Purpose: Urological management of spina bifida patients is controversial. The goals of therapy of neurogenic bladder are continence, prevention of infections and preservation of urinary tract. Desmopressin has been recently used in a spina bifida population that is dry during the day (daytime continence was achieved with clean intermittent catheterization and anticholinergics) but wet at night.