Introduction: Most authors would agree that renal parenchymal defects (scars, hypoplasia, dysplasia) in children are a major risk factor for chronic renal failure, and for development of systemic hypertension in later years. The pathophysiologic changes in acute pyelonephritis include tubulointerstitial inflammation/pus with impairment of the renal microcirculation due to compression of the glomeruli, small peritubular capillaries and vasa recta by interstitial edema. The resulting ischemia has been postulated as one of the mechanisms for the decreased accumulation of DMSA in the areas of pyelonephritis. DMSA scanning has a sensitivity of up to 99%, and specificity of up to 91% for the detection of acute pyelonephritis.
Aim Of The Study: The aim of the study was to investigate the value of Tc99m-DMSA scan in children with acute urinary tract infection, to estimate the degree of parenchymal changes, and to assess the relationship with vesicoureteral reflux.
Patients: We reviewed 116 infants aged 0-15 years, 100 (86.2%) female and 16 (13.8%) male, who were hospitalized for urinary tract infection during a 5-year period (1996-2000). The mean age at diagnosis was 3.7 years.
Results: Escherichia colli was isolated in 52 (44.8%) urine cultures. All patients underwent ultrasonography, which was normal in 57 (49.1%) infants. Tc99m-DMSA was performed after two weeks of therapy. The renal parenchymal pathology was defined as a focal or multifocal defect of low degree in 33 (28.4%), and of high degree in 35 (30%) children. Multifocal defects were mostly found in patients aged < 3 years, and focal lesions in those aged > 3 years. Renal scars were detected in 41 (35.3%) infants with first urinary tract infection.
Conclusion: We recommend that ultrasound, DMSA and radionuclide cystouretherogram be routinely performed in case of first urinary tract infection in infants aged < 1 year, and voiding cystourethrogram with US and DMSA in those aged > 1 year.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
The efficacy analysis of robotic versus laparoscopic ipsilateral uretero-ureterostomy for upper urinary tract duplications in pediatric population.
Pediatr Surg Int
January 2025
Department of Pediatric Surgery, First Affiliated Hospital, Zhengzhou University, Zhengzhou, 450052, China.
Objective: To review and compare robot-assisted ipsilateral ureteroureterostomy (RALUU) and laparoscopic ipsilateral uretero-ureterostomy (LUU) in terms of efficacy and outcomes.
Methods: Clinical data of 65 children with complete renal ureteral duplication deformity admitted to the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2022 were collected. Among these, 42 patients underwent laparoscopic ureteroureterostomy (LUU), designated as the LUU group, while 23 patients received robot-assisted laparoscopic ureteroureterostomy (RALUU), designated as the RALUU group.
Sustained effects of bladder point-of-care ultrasound simulation exercise on nursing students: A prospective cohort study.
BMC Med Educ
January 2025
School of Nursing, Seirei Christopher University, Hamamatsu, Shizuoka, Japan.
Background: Point-of-care ultrasound (POCUS) can be used in a variety of clinical settings and is a safe and powerful tool for ultrasound-trained healthcare providers, such as physicians and nurses; however, the effectiveness of ultrasound education for nursing students remains unclear. This prospective cohort study aimed to examine the sustained educational impact of bladder ultrasound simulation among nursing students.
Methods: To determine whether bladder POCUS simulation exercises sustainably improve the clinical proficiency regarding ultrasound examinations among nursing students, evaluations were conducted before and after the exercise and were compared with those after the 1-month follow-up exercise.
Protective effect of Panax ginseng extract on cisplatin-induced AKI via downregulating cell death associated genes.
Sci Rep
January 2025
Department of Clinical Biochemistry, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
This study is designed to assess the effect of root extract of P. ginseng on kidney tissue injury attributed to cisplatin and its molecular mechanism involved in this process in the AKI rat model. Twenty-four male Wistar rats were randomly allocated into 4 experimental groups including: the control group, the cisplatin group, the extract 100 mg/kg group, and the extract 200 mg/kg group.
View Article and Find Full Text PDFWhole cranberry fruit powder supplement reduces the incidence of culture-confirmed urinary tract infections in females with a history of recurrent urinary tract infection: A 6-month multicenter, randomized, double-blind, placebo-controlled trial.
Am J Clin Nutr
January 2025
Freemasons Centre for Male Health & Wellbeing, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Background: High prevalence of urinary tract infections (UTI), including cystitis, and concern for antimicrobial resistance justify safe and effective non-antibiotic therapies for prevention of recurrent UTI (rUTI). This study investigated the effect of a whole cranberry fruit powder supplement on incidence of culture-confirmed UTI (primary outcome) in females with rUTI history.
Methods: This multicenter, 6-month, randomized, placebo-controlled, double-blind study enrolled 150 healthy females (18-65 years, body mass index (BMI) >17.
First evidence of human infection by the kinetoplastid flagellate Dimastigella trypaniformis in a patient with urinary tract infection.
Int J Infect Dis
January 2025
Molecular Microbiology Laboratory, Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA. Electronic address:
We present a case of an 88-year-old man with symptoms consistent with a urinary tract infection, whose diagnostic workup uncovered a previously unrecognized motile flagellated protozoan. Molecular identification confirmed the organism as Dimastigella trypaniformis, a free-living kinetoplastid from the Rhynchomonadidae family. Known only from soil samples in Scotland and termite gut contents in Australia and Germany, Dimastigella trypaniformis has not been previously reported to infect vertebrate hosts.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!