Impact of the hyperchloremic component of metabolic acidosis on the patient's hydration status and the treatment of diabetic ketoacidosis.

Introduction: Diabetic ketoacidosis (DKA) is characterized by metabolic acidosis (MA) with a high anion gap (AG), although, occasionally, it can present with hyperchloremia. It has been postulated that the early presence of hyperchloremia could reflect a better hydration status; however, its prevalence and impact on DKA treatment remain unknown. determine the prevalence of the hyperchloremic component in MA prior to treatment and to assess whether it is associated with a better hydration status and a shorter recovery time from DKA compared to patients with high AG only.

[Using Objective Structured Clinical Examination (OSCE) across different levels of pediatric training].

Background: To evaluate professional competences is the main goal of every training program; the Objective Structured Clinical Examination (OSCE) is a useful tool for this task.

Objective: We describe OSCE administration across three different levels of pediatric training (postgraduate, internship and graduate medical education).

Methods: Regarding the most common pediatric scenarios, knowledge, clinical judgment and communicational skills were evaluated.

Idiopathic hypercalciuria in children with urinary tract infection.

Introduction: Idiopathic hypercalciuria (IH) predisposes to urinary tract infections (UTIs); however, there is scarce local information regarding such association. Our objectives were to estimate IH prevalence in children with UTI and to assess whether there were differences in relation to the presence or absence of vesicoureteral reflux (VUR). Additionally, the association between IH and salt intake was studied.

Early erythropoietin in post-diarrheal hemolytic uremic syndrome: a case-control study.

Background: Although erythropoietin (EPO) deficiency has been reported in children with post-diarrheal hemolytic uremic syndrome (D + HUS), very limited clinical data on EPO use in this disease are currently available. In this case-control study we examined whether EPO administration would reduce the number of red blood cell (RBC) transfusions in D + HUS patients under our care.

Methods: Data from children treated exclusively with RBC transfusions (controls; n = 21) were retrospectively compared with data on those who also received EPO for the treatment of anemia (cases; n = 21).

Laboratory predictors of acute dialysis in hemolytic uremic syndrome.

Background: Strict guidelines on use of dialysis in children with post-diarrheal hemolytic uremic syndrome (D + HUS) are lacking. This study investigated laboratory predictors of acute dialysis because they are more objective than clinical features. Added to this, given that urine output is also an objective parameter, its ability to predict dialysis requirements was also investigated.

Acute kidney injury in critically ill children: incidence and risk factors for mortality.

Introduction: Acute kidney injury is a common complication associated with an increase in mortality in children who require intensive care. The objective of this study was to determine the incidence of acute kidney injury and identify risk factors for mortality in critically ill patients hospitalized in our facility.

Patients And Methods: This was a prospective and observational study conducted at the Intensive Care Unit (ICU) of Hospital Pedro de Elizalde between 2005 and 2009.

Impact of platelet transfusions in children with post-diarrheal hemolytic uremic syndrome.

Background: Platelet transfusions should be avoided in children with post-diarrheal hemolytic uremic syndrome (D + HUS) because they might increase microthrombi formation, thereby aggravating the disease. As this possibility has not yet been explored, we investigated whether platelet transfusion in patients with D + HUS would lead to a worse disease course compared to that in patients who did not receive platelet transfusion.

Methods: This was a case-control study in which data from D + HUS children who received platelet transfusions (cases, n  =  23) and those who did not (controls, n  =  54) were retrospectively reviewed and compared.

[Capacity of the oligoanuric period in the prediction of renal sequelae in patients with postdiarrheal hemolytic uremic syndrome].

Introduction: Length of the oligoanuric period is the main predictor of renal sequelae in children with postdiarrehal hemolytic uremic syndrome (D+ HUS). We aimed to determine the capacity of the oligoanuric period in the prediction of renal sequelae in children with D+ HUS.

Patients And Methods: We reviewed data from all patients with D+ HUS admitted at Hospital Elizalde between 1998-2008, including only those with at least 1 year of follow-up.

Dehydration at admission increased the need for dialysis in hemolytic uremic syndrome children.

Background: Oligoanuric forms of postdiarrheal hemolytic uremic syndrome (D+ HUS) usually have more severe acute stage and higher risk of chronic sequelae than nonoligoanuric forms. During the diarrheal phase, gastrointestinal losses could lead to dehydration with pre-renal injury enhancing the risk of oligoanuric D+ HUS. Furthermore, it had been shown that intravenous volume expansion during the prodromal phase could decrease the frequency of oligoanuric renal failure.

[Assessing a test to evaluate clinical analytical thinking according to medical training level].

Background: MATCH (Measuring Analytical Thinking in Clinical Health Care) is an instrument to evaluate clinical reasoning.

Aim: To assess MATCH performance in professionals and students with different training in pediatrics.

Material And Methods: MATCH was administered to medical students (S), first (R1) and third (R3) year residents and staff physicians (P).