Purpose:To investigate the demographic characteristics, clinical features, and metabolic risk factors of children with urolithiasis. Materials and methods:This retrospective study included 98 patients (48 boys, 50 girls) with urolithiasis diagnosed by ultrasonography. The mean age at presentation was 59.8 months, and the mean followup period was 5.5 (1-27) months. Clinical and laboratory data including gender, age at diagnosis, presence of family history of renal stone, follow-up duration, presenting symptoms, the history of urinary tract infection (UTI), stone localization, presence of anatomical abnormalities of the urinary tract, presence of microscopic or macroscopic hematuria, pyuria, urinary metabolic examinations, blood tests, analysis of stone composition, treatment modality, and prognosis were assessed. Results: The most common symptom was restlessness in infants (<1year) and abdominal or flank pain in older children. Microcalculi (stone diameter <3mm) and calculi (>3mm) were found in 29.6% and in 70.4% of the patients, respectively. Hypercalciuria was the most common abnormality, followed by hypomagnesiuria. Nearly half of the hypercalciuria cases were <1 year old. Recurrent urinary tract infection was detected in half of the patients. Four patients underwent extracorporeal shock-wave lithotripsy, four underwent open surgery, and the other 90 were treated with conservative treatment. Spontaneous passage occurred in 17 patients. Stone analysis revealed calcium-oxalate in 82.4% of the 17patients. At the time of their last visit, 70% of the patients that were treated with conservative treatment, either had stones that disappeared or diminished in size with appropriate therapy. Conclusion: In terms of stones disappearance or decrease in the size of the stones, it seems that children younger than 1 year have more disadvantages than older children. Microcalculi in children should be taken into consideration because we found that 3/5 of these cases had urinary metabolic abnormalities. Pam Med J 2015;8(1):11-17Özet Amaç: Ürolitiazisli çocukların demografik, klinik özelliklerini ve metabolik risk faktörlerini araştırmak. Gereç ve yöntem: Bu retrospektif çalışmada ultrasonografi ile tanı alan ürolitiazisli 98 hasta ( 48 erkek, 50 kız ) çalışmaya alındı. Başvuru yaş ortalaması 59.8 ( 1-192 ) ay ve takip süresi ( 1-27 ) ortalama 5,5 aydı. Klinik ve laboratuvar bulgular olarak cinsiyet, tanı anındaki yaş, ailede üriner taş hikayesi, izleme periyodu, başlangıç semptomları, idrar yolu enfeksiyon öyküsü, mikroskobik veya makroskobik hematüri varlığı, piyüri, üriner metabolik hastalık, kan tetkikleri, taş analizi, tedavi modalitesi ve prognoz belirlendi. Bulgular: En sık görülen belirti bebeklerde huzursuzluk ( < 1 yaş) ve daha büyük çocuklarda karın veya yan ağrısıydı. Mikrokalkul ( taş çapı < 3mm ) ve kalkül (taş çapı > 3mm ), hastaların sırasıyla % 29.6 ve % 70.4 'ünde saptandı. Hiperkalsiüri hastalarda en sık saptanan anormallik olurken, hipomagnezüri 2. sıklıkta onu takip etti. Hiperkalsiüri olgularının yaklaşık y...
Abstractsstones were disappeared or diminished in size by appropriate therapy such as water intake, diet, hydrochlorothiazide and potassium-citrate. Conclusion Identifying the underlying metabolic risk factor is important in order to choose the appropriate treatment modality, prevent stone recurrence and renal damage. Patients presenting with restlessness, especially infants must be evaluated in terms of renal stone disease by ultrasonography. Tc-Dimercaptosuccinic acid and voiding cystourethrography were performed in all patients. The patients were grouped by age according to presumed risk of renal damage: high risk(≤1 year), moderate risk(1-5 years), and low risk (>5 years). Results Renal lesions on RCS were detected in 91 patients. Abnormal RCS were found in 35% of infants younger than 1 year, in 57% of children between 1-5 years and in 42% of children older than 5 years. Abnormal RCS was found in 66% of the children with VUR and in 42.7% of those without VUR(p=0.005). There was a significant positive correlation between abnormal RCS and VUR, duration of fever (>2 days), history of recurrent UTI, high levels of ESR, CRP, WBC, and PNL at the presentation. Conclusion The patients with VUR were 2.6 times more likely to have renal damage. The risk of renal damage should be considered in all age groups. Background and Aims Peripherally inserted central venous catheters (PICCs) are commonly used for neonatal vascular access. Early catheter-related sepsis and catheter non infectious complications are linked with initial dressing method. We evaluate efficacy of our specific PICCs insertion protocol with trained nurses and doctors. Methods We observed prospectively 1686 PICC procedures in neonate (0-28d) from 2002 to 2011. Silicon PICCs were inserted from 0 to 28 days corrected age. Procedure followed our specific protocol. Results 1686 PICCs were attempted with a success rate of 96.2% in neonates with a mean gestational age of 29.7 weeks at a median age of 3 (0-94d) days of life. THE CORRELATION BETWEEN RENAL DAMAGE AND CLINICAL AND LABORATORY FINDINGS IN CHILDREN WHOLE EXON DELETION IN THEIn the successful PICCs, median number of venous puncture was 1 (1-13), median time spent was 20 (5-120) minutes, device change in 11.7% and site change in 5.9%. Median temperature difference between the beginning and the end of the procedure was very low: -0.2°C (-1.5 to 1.8). 187 complications (11.5%) occurred: 105 diffusions of which 6 pericardic effusions, 25 occlusions, 37 porous catheters, 7 surrounding catheter tissue inflammations. 13 PICCs were removed for infection (sepsis or local mycosis). Conclusions Standardized protocol with specific nurse and doctor leads to a success rate of 96.2% with a small time spent for insertion and a median of one attempt mostly in the initial chosen site. This quick method leads to low neonate cooling and expose patients to minimal infection risk and complications. Objective To investigate the demographic characteristics, clinical features, and metabolic risk factors of children with urolit...
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