Children with cancer: a survey on the experience of Italian primary care pediatricians.

Background: Cancer is the second cause of death in children and its diagnosis can be difficult, due to the presence of vague and non-specific symptoms. The primary care pediatrician is often involved in the diagnostic process, but no longer in child care once the treatment started. Care models involving both primary care pediatricians and oncologic referral centre highlighted a higher family satisfaction when they worked together.

Ultrasound detection of pneumonia in febrile children with respiratory distress: a prospective study.

Unlabelled: To analyse the usefulness of bedside lung ultrasound (LUS) in detecting lung consolidation in a paediatric emergency room (ER) setting, febrile children seen at our ER from 2008 to 2012 with a moderate to severe respiratory distress underwent LUS, chest X-ray (CXR) and laboratory investigations. At first ER assessment, LUS identified a lung consolidation in 207 patients of 222 children enrolled, with a liver-like appearance in 75 (36.2%) and an associated pleural effusion in 36.

Febrile urinary tract infections in young children: recommendations for the diagnosis, treatment and follow-up.

Unlabelled: We report the recommendations for the diagnosis, treatment, imaging evaluation and use of antibiotic prophylaxis in children with the first febrile urinary tract infection, aged 2 months to 3 years. They were prepared by a working group of the Italian Society of Pediatric Nephrology after careful review of the available literature and a consensus decision, when clear evidence was not available.

Conclusion: These recommendations are endorsed by the Italian Society of Pediatric Nephrology.

Prediction of moderate and high grade vesicoureteral reflux after a first febrile urinary tract infection in children: construction and internal validation of a clinical decision rule.

Purpose: Urinary tract infection leads to a diagnosis of moderate or high grade (III or higher) vesicoureteral reflux in approximately 15% of children. Predicting reflux grade III or higher would make it possible to restrict cystography to high risk cases. We aimed to derive a clinical decision rule to predict vesicoureteral reflux grade III or higher in children with a first febrile urinary tract infection.

Procalcitonin is a predictor for high-grade vesicoureteral reflux in children: meta-analysis of individual patient data.

Objective: To assess the predictive value of procalcitonin, a serum inflammatory marker, in the identification of children with first urinary tract infection (UTI) who might have high-grade (≥3) vesicoureteral reflux (VUR).

Study Design: We conducted a meta-analysis of individual data, including all series of children aged 1 month to 4 years with a first UTI, a procalcitonin (PCT) level measurement, cystograms, and an early dimercaptosuccinic acid scan.

Results: Of the 152 relevant identified articles, 12 studies representing 526 patients (10% with VUR ≥3) were included.

Autoimmune thyroid disease in Libyan children and young adults with type 1 diabetes mellitus.

Unlabelled: Diabetes mellitus is a common autoimmune endocrine disorder associated with organ-specific autoantibodies which are frequently detected at the time of diagnosis. Some of these antibodies are specific to the pancreas (GAD, IA2, ICA) while others are related to different autoimmune diseases.

Aim Of The Study: To define the prevalence of thyroid autoimmune disease in Libyan patients with type 1 diabetes mellitus (T1DM) since no similar studies have been performed in Libya.

Radiological treatment of renal artery occlusion after blunt abdominal trauma in a pediatric patient: is it never too late?

A 15-year-old boy was severely injured in a motor vehicle accident. A blunt abdominal trauma resulted in multiple lesions requiring urgent surgical treatment. Seven days after the trauma, renal Doppler sonography showed absence of arterial signal in the left kidney hilum.

Age-related renal parenchymal lesions in children with first febrile urinary tract infections.

Objective: The aim of this study was to define the association between age and the occurrence of acute pyelonephritis and renal scars.

Methods: Between 1999 and 2002, all children 0 to 14 years of age consecutively seen with a first febrile urinary tract infection were enrolled in the study. (99m)Tc-Dimercaptosuccinic acid renal scintigraphy was performed within 5 days after admission for the detection of renal parenchymal involvement.

Procalcitonin and pyelonephritis in children.

Purpose Of Review: In the past few years, procalcitonin has been proposed as a sensitive and specific inflammatory marker in various fields of medicine, especially in infectivology, where it has been used to discriminate between bacterial infections, viral infections and inflammation processes. Recently, different studies have emerged in the literature on the use of this marker to identify renal involvement in febrile urinary tract infections.

Recent Findings: Procalcitonin seems to be a valid biological marker, with an acceptable sensitivity and specificity, which predicts a renal involvement of the infection (pyelonephritis), in comparison with the low specificity of C-reactive protein.

Procalcitonin: a marker of severity of acute pyelonephritis among children.

Objective: Febrile urinary tract infection (UTI) is a common problem among children. The diagnosis and management of acute pyelonephritis is a challenge, particularly during infancy. The distinction between acute pyelonephritis and UTI without renal involvement is very important, because renal infection may cause parenchymal scarring and thus requires more aggressive investigation and follow-up monitoring.