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Objetivos: As infeções do trato urinário (ITU) são das infeções bacterianas mais frequentes em pediatria. O exame bacteriológico da urina (EBU) é o teste referência para o diagnóstico de ITU. Sendo um exame moroso, a decisão de iniciar antibioterapia baseia-se na clínica e na urinálise (ASU). A suspeita de ITU na criança e adolescente poderá ser orientada pelo médico de família. O objetivo deste estudo foi avaliar a eficácia da ASU no diagnóstico precoce da ITU em idade pediátrica. Métodos: Efetuou-se um estudo observacional que incluiu doentes (0-18 anos) que recorreram à urgência pediátrica entre 01/01/2015 e 31/12/2016 e que realizaram colheita de urina para ASU e EBU. Foram analisados os resultados da ASU e comparados com os resultados do EBU. Atribuiu-se diagnóstico definitivo de ITU a todos os doentes com EBU positivo. Determinou-se a sensibilidade, especificidade, valor preditivo positivo (VPP), valor preditivo negativo (VPN) e odds ratio (OR) dos parâmetros nitritos e esterase leucocitária (EL) para o diagnóstico de ITU. Resultados: Das 3.400 amostras incluídas, 21,2% tiveram resultado bacteriológico positivo. O microrganismo mais frequente foi Escherichia coli. Os nitritos demonstraram sensibilidade de 28% e especificidade de 99% para o diagnóstico. A EL revelou sensibilidade de 90% e especificidade de 63%. Para o conjunto dos dois, a sensibilidade foi de 27% e a especificidade de 99%, com VPP 91% e VPN 83%. Para EL superior a 500 células/mcl verificou-se especificidade de 93%. No grupo etário 0-12 meses verifica-se um VPP 93% e VPN 82% para os dois em conjunto. Conclusões: Os resultados são concordantes com a literatura: a EL é sensível para o diagnóstico de ITU e os nitritos são específicos. O melhor indicador para exclusão de ITU foi a EL. Estes resultados poderão ser aplicados na consulta aberta de saúde infantil e juvenil ao nível dos cuidados de saúde primários.

Funding Acknowledgements Type of funding sources: None. Background Heart failure (HF) is characterized by functional limitation and consequent loss of quality of life. These parameters can be measured through self-evaluated instruments, namely Duke activity status index (DASI) and Minnesota living with heart failure questionnaire (MLHFQ). In parallel, HF is also characterized by objective parameters measured by complementary diagnostic tests, namely NT-proBNP and left ventricular ejection fraction by echocardiogram. Patients with higher NT-proBNP value and worse ejection fraction may present with more symptoms and consequently functional impairment and worse quality of life. Aim To analyze if self-reported parameters present significant correlation with objective measured parameters and to understand if there are differences between gender in out-patients followed in advanced heart failure assessment. Methods During the year of 2022, a cohort of out-patients was analyzed. Data was collected regarding DASI, MLHFQ and disease stratification based on NT-proBNP and left ventricular ejection fraction by echocardiogram. Pearson's correlation was made between these parameters, trying to understand whether they were related to them and whether this relationship is in line with the patient's clinical presentation. An independent sample T-test was performed in order to understand any differences regarding the gender. Results A sample of 122 patients were evaluated; 97 (80%) were male, with a mean age of 63 years. New York Heart association functional class was between II and III and all patients had reduced left ventricular ejection fraction, with an average of 35% (min: 10% and max: 48%). NT-proBNP scores are quite high, presenting an average score of 1349.7±1482.5. Average score of MLHFQ was 13±15, meaning that patients present a good quality of life and DASI average score was 33.9±16.1, meaning a very acceptable functional capacity level. The DASI score correlates negatively with MLHFQ (r = -0.566, p = 0.003) and with NT-proBNP value (r = -0.783, p = 0.000); MLHFQ score is positively correlated with NT-proBNP value (r = 0.018, p = 0.000). A high DASI score corresponds to good functional capacity and, as such, better quality of life and lower physiological impact of the disease. Surprisingly, despite the lower MLHFQ and high DASI, patients present a quite increase level of NT-proBNP. There were no gender differences in relation to the DASI score (p = 0.077) and MLHFQ (p = 0.422). Conclusion The self-evaluated parameters correlate with the physiological parameters objectively measured. The perception of patients regarding their quality of life and functional capacity may not allow to infer about their physiological parameters, since a high NT-proBNP a low left ventricular ejection fraction normally indicates a worse functional level, which is not observed in this cohort of patients. Gender seems to have no impact on the level of quality of life or self-reported functional capacity.

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