Single donor-derived strongyloidiasis in three solid organ transplant recipients: case series and review of the literature.

Donor-derived Strongyloides stercoralis infections in transplant recipients are a rare but recognized complication. In this case series, we report donor-derived allograft transmission of Strongyloides in three solid organ transplant recipients. Following detection of infection in heart and kidney-pancreas recipients at two different transplant centers, a third recipient from the same donor was identified and diagnosed.

A simplified table improves the recognition of paediatric hypertension.

Aim: Unrecognised and untreated hypertension can lead to significant morbidity and mortality over time. In a 2003 chart review, we found that our providers only recognised 15% of hypertensive blood pressure (BP). Our objective was to determine whether a simplified BP table improves the recognition of elevated BP in children.

Extracorporeal CO2 removal in a child with a single ventricle by the addition of an oxygenator to a dialysis circuit.

Objective: To optimize CO2 removal in a child with a single ventricle.

Design: Case report.

Setting: A ten-bed pediatric intensive care unit in a university-affiliated hospital.

Short-course versus conventional length antimicrobial therapy for uncomplicated lower urinary tract infections in children: a meta-analysis of 1279 patients.

Objective: The objective was to compare the efficacies of single-dose, short-course (4 days or less), and standard course (5 days or greater) antimicrobial therapy for uncomplicated childhood cystitis.

Methods: Prospective, randomized, controlled trials comparing 4 days or less of therapy (short courses) with 5 days or more of therapy (conventional therapy) were included if all of the subjects were <18 years of age, the initial infection was documented by urine culture, at least 1 subsequent culture was obtained between 3 and 30 days of enrollment, and some attempt was made to separate upper tract from lower tract infection. Composite differences among treatment groups were compared with a fixed or random effects model, depending on the test for heterogeneity.

Renal transplantation in a patient with common variable immunodeficiency.

A 15-year-old girl developed end-stage renal disease requiring renal transplantation. Posttransplantation immunosuppression therapy consisted of antithymocyte globulin, glucocorticosteroids, cyclosporine A, and azathioprine. The patient's clinical course after transplantation was complicated by several episodes of graft rejection, chronic anemia, oral candidiasis, and numerous infections of the sinopulmonary tract that were recalcitrant to antibiotics and surgical intervention.

Evolution of chronic nitric oxide inhibition hypertension: relationship to renal function.

We conducted longitudinal measurements of blood pressure and renal function in the conscious, chronically catheterized rat before and during acute nitric oxide synthase inhibition (N-nitro-L-arginine methylester [L-NAME], 37 micromol/kg IV) and then chronic administration of oral L-NAME (approximately 37 micromol/kg per 24 hours). These studies specifically investigate the impact on plasma and renal renin as well as volume status during the evolution of this hypertension in rats not subjected to acute experimental stress. Blood pressure progressively increased with chronic administration of L-NAME and reached values greatly above those seen with acute administration of L-NAME.

Persistent severe hypertension in an infant with posterior urethral valves.

Severe hypertension, an infrequent problem in pediatrics, usually has a single secondary cause. We report an infant with severe hypertension and left reflux nephropathy, a known cause of secondary hypertension. The severity of hypertension and poor response to pharmacological therapy prompted further investigation, including a renal arteriogram that showed a right segmental renal artery stenosis.

Regulation of the renal response to atrial natriuretic peptide by sodium intake in preweaned rats.

The neonate conserves sodium avidly, and sodium intake is normally limited to that present in maternal milk. To evaluate the role of atrial natriuretic peptide (ANP) in this adaptation, preweaned rat pups were artificially reared and fed a formula with either normal sodium (25 mEq/L) or high sodium (145 mEq/L) for 7-8 d. To determine whether increased dietary sodium decreases ANP clearance receptor activity, animals were anesthetized, and the plasma ANP concentration (ANPp), urine flow (V), urinary sodium (UNa V), and cGMP excretion (UcGMP V) were measured before and after infusion of ANF(4-23), an ANP clearance receptor inhibitor (C-ANF), at 50 micrograms/kg/ min.

Salt intake modulates the developmental expression of renal kallikrein and bradykinin B2 receptors.

The mechanisms involved in the postnatal induction of renal kallikrein gene transcription and enzymatic activity are unknown. The present study was designed to test the hypothesis that salt (NaCl) intake regulates the ontogeny of renal kallikrein gene expression and enzymatic activity and urinary kallikrein excretion. Newborn rats were artificially fed via a gastric tube with a milk formula containing either normal (25 meq/l, same as in maternal milk) or high (145 meq/l) NaCl content from day 7 to 14 of postnatal life.

Chronic sodium loading augments natriuretic response to acute volume expansion in the preweaned rat.

Positive sodium balance is necessary for normal somatic growth of the neonate, and the neonatal renal response to volume expansion (VE) is attenuated compared with the adult. To test the hypothesis that dietary sodium modulates the developmental response to VE, preweaned rats were artificially reared with either a normal (25 meq/l)- or high-sodium (145 meq/l) diet for 7-8 days and were compared with adult rats receiving normal or high sodium. Serum sodium concentration remained normal in adults on high sodium, whereas neonates became hypernatremic.

Dietary sodium modulates neonatal but not adult cardiac atrial natriuretic peptide in rats.

After an initial postnatal diuresis, neonates are in positive sodium balance. Because atrial natriuretic peptide (ANP) contributes to sodium homeostasis, this study was designed to evaluate the maturational effects of increased dietary sodium intake on cardiac ANP production. Preweaned Sprague-Dawley rat pups were artificially reared by feeding them either a normal-sodium or high-sodium diet for 7 d and were compared with maternally reared rat pups.

Prenatal maternal indomethacin use resulting in prolonged neonatal renal insufficiency.

The short-term use of indomethacin has been shown to be relatively safe and effective in halting premature labor. Its use has been associated with adverse renal effects in both the fetal and newborn periods that are generally transient and resolve on discontinuation of the drug. However, limited data suggest that prolonged prenatal exposure to indomethacin may be harmful to the fetus.