The burden of early-onset sepsis in Emilia-Romagna (Italy): a 4-year, population-based study.

Objective: To provide the first Italian data on pathogens causing early-onset sepsis (EOS) and their antimicrobial susceptibility, after the successfully prevention of Group B streptococcus (GBS) EOS.

Methods: Retrospective area-based cohort study from Emilia-Romagna (Italy). Cases of EOS registered (from 2009 to 2012) in all gestational age neonates were reviewed.

Acute pyelonephritis in children.

Acute pyelonephritis is one of the most serious bacterial illnesses during childhood. Escherichia coli is responsible in most cases, however other organisms including Klebsiella, Enterococcus, Enterobacter, Proteus, and Pseudomonas species are being more frequently isolated. In infants, who are at major risk of complications such as sepsis and meningitis, symptoms are ambiguous and fever is not always useful in identifying those at high risk.

Nephrotic-range Albuminuria as the presenting symptom of Dent-2 disease.

Unlabelled: Dent disease is a rare X-linked tubulopathy with low molecular weight proteinuria, hypercalciuria, nephrolithiasis, nephrocalcinosis and progressive renal failure. We describe the case of a 9-year-old boy who presented with nephrotic-range albuminuria at the age of 3 years. In the absence of a clear diagnosis, a renal biopsy was performed at 4 years, which revealed minimal change disease.

Considerable variations in growth hormone policy and prescription in paediatric end-stage renal disease across European countries-a report from the ESPN/ERA-EDTA registry.

Background: Growth retardation in paediatric end-stage renal disease (ESRD) has a serious impact on adult life. It is potentially treatable with recombinant growth hormone (rGH). In this study, we aimed to quantify the variation in rGH policies and actual provided care in these patients across Europe.

Current primary care management of children aged 1-36 months with urinary tract infections in Europe: large scale survey of paediatric practice.

Objective: To describe current practice among European paediatricians regarding diagnosis and management of urinary tract infections in children aged 1-36 months and to compare these practices with recently published guidelines.

Design: Web-based large scale survey evaluating knowledge of, attitudes towards and the methods for diagnosing, treating and managing urinary tract infections in children.

Setting: Primary and secondary care practices in Europe.

Best practice guidelines for idiopathic nephrotic syndrome: recommendations versus reality.

Background: The optimal therapeutic regimen for managing childhood idiopathic nephrotic syndrome (INS) is still under debate. We have evaluated the choice of steroid regimen and of symptomatic treatment adopted by pediatricians and pediatric nephrologists in a large number of centers as the first step towards establishing a shared protocol

Methods: This was a multicenter, retrospective study. A total of 231 children (132 admitted to pediatric units) aged 6 months to <15 years who presented with onset of nephrotic syndrome to 54 pediatric units and six pediatric nephrology units in Italy between 2007 and 2009 were eligible for entry into the study.

Identification of children and adolescents at risk for renal scarring after a first urinary tract infection: a meta-analysis with individual patient data.

Importance: No studies have systematically examined the accuracy of clinical, laboratory, and imaging variables in detecting renal scarring in children and adolescents with a first urinary tract infection.

Objectives: To identify independent prognostic factors for the development of renal scarring and to combine these factors in prediction models that could be useful in clinical practice.

Data Sources: MEDLINE and EMBASE.

Renal involvement in hypocomplementaemic urticarial vasculitis syndrome: a report of three paediatric cases.

Objective: To describe the diagnosis and management of renal disease in three paediatric cases of hypocomplementaemic urticarial vasculitis syndrome (HUVS).

Methods: Three children who were diagnosed with HUVS and developed abnormalities of renal function during the disease course are described.

Results: Urinary findings were heterogeneous: all the patients developed persistent microhaematuria, which was isolated in patient 1, associated with mild proteinuria in patient 2 and with nephrotic syndrome in patient 3.

Different guidelines for imaging after first UTI in febrile infants: yield, cost, and radiation.

Objective: To evaluate the yield, economic, and radiation costs of 5 diagnostic algorithms compared with a protocol where all tests are performed (ultrasonography scan, cystography, and late technetium(99)dimercaptosuccinic acid scan) in children after the first febrile urinary tract infections.

Methods: A total of 304 children, 2 to 36 months of age, who completed the diagnostic follow-up (ultrasonography, cystourethrography, and acute and late technetium(99)dimercaptosuccinic acid scans) of a randomized controlled trial (Italian Renal Infection Study 1) were eligible. The guidelines applied to this cohort in a retrospective simulation were: Melbourne Royal Children's Hospital, National Institute of Clinical Excellence (NICE), top down approach, American Academy of Pediatrics (AAP), and Italian Society of Pediatric Nephrology.

Accuracy of transthoracic ultrasound for the detection of pleural adhesions.

Objectives: In the era of minimally invasive surgery, preoperative detection of pleural adhesions can be very useful for the assessment of surgical approach, because pleural adhesions are the main contraindication to video-assisted thoracoscopy. The aim of this study was to assess the sensitivity and specificity of transthoracic ultrasound in the detection of pleural adhesions prior to thoracic surgery.

Methods: From February 2010 to January 2011, 142 consecutive patients (male, 98; female, 44; age range, 36-83 years, mean age, 63.

Pediatric febrile urinary tract infections: the current state of play.

Studies undertaken in recent years have improved our understanding regarding the consequences and management of febrile urinary tract infections (UTIs), which are amongst the most common serious bacterial infections in childhood, with renal scarring a frequent outcome. In the past pyelonephritic scarring of the kidney, often associated with vesico-ureteral reflux (reflux nephropathy) was considered a frequent cause of chronic renal insufficiency in children. Increasing recognition as a consequence of improved antenatal ultrasound, that the majority of these children had congenital renal hypo-dysplasia, has resulted in a number of studies examining treatment strategies and outcomes following UTI.