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https://www.readbyqxmd.com/read/28737866/algorithms-imaging-tests-comparison-following-the-first-febrile-urinary-tract-infection-in-children
#1
María M Tombesi, Laura F Alconcher, Lucas Lucarelli, Agustina Ciccioli
OBJETIVES: To compare the diagnostic sensitivity, costs and radiation doses of imaging tests algorithms developed by the Argentine Society of Pediatrics in 2003 and 2015, against British and American guidelines after the first febrile urinary tract infection (UTI). POPULATION AND METHODS: Inclusion criteria: children ≤ 2 years old with their first febrile UTI and normal ultrasound, voiding cystourethrography and dimercaptosuccinic acid scintigraphy, according to the algorithm established by the Argentine Society of Pediatrics in 2003, treated between 2003 and 2010...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28710643/-vesicoureteral-reflux-watchful-waiting-surgery-or-antibiotic-prophylaxis
#2
REVIEW
A Schröder
Primary vesicoureteral reflux (VUR) is a dynamic disease with several factors influencing its course. Therapeutic options range from watchful waiting to open surgery. Multiple risk factors for the development of pyelonephritis are identified, which then determine the decision for the appropriate treatment option. They include age, gender, history of pyelonephritis and renal scarring, bladder and bowel dysfunction (BBD), circumcision status and parental preference. The use of continuous antibiotic prophylaxis (CAP) is becoming increasingly controversial with antibiotic resistance being a major concern...
July 14, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28694079/distal-ureteral-diameter-ratio-is-predictive-of-breakthrough-febrile-urinary-tract-infection
#3
Angela M Arlen, Traci Leong, Paul J Guidos, Siobhan E Alexander, Christopher S Cooper
PURPOSE: Distal ureteral diameter ratio (UDR) is an objective measure that is prognostic of spontaneous vesicoureteral reflux (VUR) resolution. Along with likelihood of resolution, improved identification of children at risk for recurrent febrile urinary tract infections (fUTI) may impact management decisions. We evaluated the utility of UDR as a predictive factor for breakthrough fUTI. MATERIALS AND METHODS: Children with primary VUR and detailed voiding cystourethrogram (VCUG) were identified...
July 7, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28681079/urinary-tract-infection-in-small-children-the-evolution-of-renal-damage-over-time
#4
Svante Swerkersson, Ulf Jodal, Rune Sixt, Eira Stokland, Sverker Hansson
BACKGROUND: Our objective was to analyze the evolution of kidney damage over time in small children with urinary tract infection (UTI) and factors associated with progression of renal damage. METHODS: From a cohort of 1003 children <2 years of age with first-time UTI, a retrospective analysis of 103 children was done. Children were selected because of renal damage at index (99m)Tc-dimercaptosuccinic acid (DMSA) scintigraphy at least 3 months after UTI, and a late DMSA scan was performed after at least 2 years...
July 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28638940/laparoscopic-vesico-ureteral-reimplantation-with-lich-gregoir-approach-in-children-medium-term-results-of-159-renal-units-in-117-children
#5
Victor Soulier, Aure Lien Scalabre, Manuel Lopez, Chi-Ying Li, Sodara Thach, Sophie Vermersch, Franc Ois Varlet
PURPOSE: Vesico-ureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Surgery is an important part of its management. Laparoscopic ureteric reimplantation using the Lich-Gregoir technique is an option for VUR. The aim of this study is to assess short- and medium-term outcomes of this approach. MATERIALS AND METHODS: This is a retrospective study including all children with VUR treated by laparoscopic extravesical ureteral reimplantation with the Lich-Gregoir technique in University Hospital of Saint-Etienne from August 2007 to May 2016...
June 21, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28631915/-multispiral-computer-tomography-in-differential-diagnosis-of-congenital-uretheroidhydronefrosis-in-children
#6
E B Khakkulov, Zh U Khusankhodzhaev
AIM: To identify the characteristic MSCT signs of pediatric ureterohydronephrosis allowing to assess the disease severity and differentiate between its various forms. MATERIAL AND METHODS: Sixty five children with III-IV grade ureterohydronephrosis underwent a comprehensive examination including MSCT urography. The study comprised 40 (61.5%) boys and 25 (38.5%) girls aged 3 months to 14 years (mean age 4.15+/-3.21 years). RESULTS: Obstructive disease was detected in 38 (58...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28630017/vesicoureteral-reflux-is-a-phenotype-not-a-disease-a-population-centered-approach-to-pediatric-urinary-tract-infection
#7
REVIEW
Jathin Bandari, Steven G Docimo
We performed a review of the recent literature concerning urinary tract infection (UTI) evaluation and management. In modeling options for management, one overriding conclusion became apparent: in most affected children, the presence of vesicoureteral reflux (VUR) is inconsequential since it has no bearing on optimal management or outcome. In fact, knowing that a child does not have reflux might bias the provider to withhold potentially helpful therapeutic modalities to decrease UTI morbidity, such as antibiotic prophylaxis...
May 22, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28624552/-watering-can-ureterocele-puncture-technique-leads-to-decreased-rates-of-de-novo-vur-and-subsequent-surgery-with-durable-results
#8
Joseph Haddad, Bhalaajee Meenakshi-Sundaram, Nathan Rademaker, Hubert Greger, Christopher Aston, Blake W Palmer, Bradley P Kropp, Dominic Frimberger
OBJECTIVE: To assess the outcomes of 'Watering Can' ureterocele puncture, a technique previously associated with decreased incidence of de novo VUR, as a durable option for management of ureteroceles and to determine the need for subsequent surgery for VUR following 'Watering Can' puncture. MATERIALS AND METHODS: We retrospectively reviewed records of 55 consecutive endoscopic ureterocele procedures done at our institution from 1999 to 2015. The WCP was performed using a holmium laser fiber to make 10-20 puncture holes through the ureterocele...
June 14, 2017: Urology
https://www.readbyqxmd.com/read/28617157/vesicoureteral-reflux-in-kidney-transplantation
#9
Nina M Molenaar, Robert C Minnee, Frederike J Bemelman, Mirza M Idu
BACKGROUND: Vesicoureteral reflux (VUR) is frequently found after transplantation, but its impact on graft function, urine tract infection, and graft loss remains uncertain. Therefore our objective was to evaluate the effects of VUR on the outcome of renal transplantation. MATERIAL AND METHODS: We included 1008 adult renal transplant recipients of whom a 1-week posttransplant voiding cystourethrogram was available. Study end points included occurrence of bacteriuria, renal function, and graft survival...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28612061/management-of-vesicoureteral-reflux-in-neurogenic-bladder
#10
REVIEW
Charlotte Q Wu, Israel Franco
Vesicoureteral reflux (VUR) is a significant risk factor for pyelonephritis and renal scarring. VUR can occur through a defective ureterovesical junction (UVJ) or an overwhelmed normal UVJ mechanism such as in bladder dysfunction of congenital, acquired, or behavioral etiology. There are numerous causes for the development of a neurogenic bladder from spinal dysraphisms to spinal cord trauma and even centrally based abnormalities in children with apparently normal motor function (inappropriately termed nonneurogenic neurogenic bladder)...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28612060/aggressive-diagnosis-and-treatment-for-posterior-urethral-valve-as-an-etiology-for-vesicoureteral-reflux-or-urge-incontinence-in-children
#11
REVIEW
Hideo Nakai, Taiju Hyuga, Shina Kawai, Taro Kubo, Shigeru Nakamura
Vesicoureteral reflux (VUR) is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although posterior urethral valve (PUV) is well known as a cause of the secondary VUR, it is controversial that minor urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transurethral incision...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28612058/vesicoureteral-reflux-and-continuous-prophylactic-antibiotics
#12
REVIEW
Ted Lee, John M Park
Vesicoureteral reflux (VUR) management must be tailored based on the risk for further infections and renal scarring, gender, likelihood of spontaneous resolution, and parental preferences. Because we now understand that sterile VUR is benign and most reflux spontaneously resolves over time, the initial approach in majority of children is non-surgical with continuous antibiotic prophylaxis (CAP) and correction of bladder and bowel dysfunction. Despite increasing utilization of CAP over the past four decades, the efficacy of antibiotic prophylaxis has been questioned due to conflicting results of studies plagued with design flaws and inadequate subject sample size...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28612057/imaging-studies-and-biomarkers-to-detect-clinically-meaningful-vesicoureteral-reflux
#13
REVIEW
Michaella Maloney Prasad, Earl Y Cheng
The work-up of a febrile urinary tract infection is generally performed to detect vesicoureteral reflux (VUR) and its possible complications. The imaging modalities most commonly used for this purpose are renal-bladder ultrasound, voiding cystourethrogram and dimercapto-succinic acid scan. These studies each contribute valuable information, but carry individual benefits and limitations that may impact their efficacy. Biochemical markers are not commonly used in pediatric urology to diagnose or differentiate high-risk disease, but this is the emerging frontier, which will hopefully change our approach to VUR in the future...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28612056/critical-appraisal-of-the-top-down-approach-for-vesicoureteral-reflux
#14
REVIEW
Ahmed Abdelhalim, Antoine E Khoury
Vesicoureteral reflux (VUR) has been linked to recurrent urinary tract infections (UTIs), renal scarring, hypertension, renal insufficiency and end-stage kidney disease. Different imaging strategies have been proposed to approach children presenting with UTI to sort out patients with significant VUR while minimizing patient morbidity, radiation exposure and financial burden. None of these imaging strategies is universally accepted. The"top-down approach" (TDA) aims at restricting the number of voiding cystourethrograms (VCUGs) and its associated morbidity while identifying patients with clinically-significant reflux...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28612055/genetics-of-vesicoureteral-reflux-and-congenital-anomalies-of-the-kidney-and-urinary-tract
#15
REVIEW
Keum Hwa Lee, Heon Yung Gee, Jae Il Shin
The definition of congenital anomalies of the kidney and urinary tract (CAKUT) is the disease of structural malformations in the kidney and/or urinary tract containing vesicoureteral reflux (VUR). These anomalies can cause pediatric chronic kidney disease. However, the pathogenesis of CAKUT is not well understood, because identifying the genetic architecture of CAKUT is difficult due to the phenotypic heterogeneity and multifactorial genetic penetrance. We describe the current genetic basis and mechanisms of CAKUT including VUR via approaching the steps and signaling pathways of kidney developmental processes...
June 2017: Investigative and Clinical Urology
https://www.readbyqxmd.com/read/28594594/laparoscopic-assisted-extravesical-ureteral-reimplantation-and-extracorporeal-ureteral-tapering-repair-for-primary-obstructive-megaureter-in-children
#16
Manuel Lopez, Romy Gander, Gloria Royo, François Varlet, Marino Asensio
BACKGROUND: Open surgery is a preferred treatment for primary obstructive megaureter (POM) in cases where the conservative treatment fails, with reported success rates of 90%-96%. OBJECTIVE: To describe our initial experience in the treatment of POM by laparoscopic-assisted extracorporeal ureteral tapering repair (EUTR) and laparoscopic ureteral extravesical reimplantation (LUER) by following Lich Gregoir technique as an alternative to open surgery. DESIGN, SETTING, AND PARTICIPANTS: A total of 7 patients with POM underwent laparoscopic-assisted extracorporeal ureteral tapering repair and ureteral extravesical reimplantation by following Lich Gregoir technique between 2011 and 2014...
June 8, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28592391/long-term-fate-of-the-upper-tracts-following-complete-primary-repair-of-bladder-exstrophy
#17
Jonathan S Ellison, Jennifer Ahn, Margarett Shnorhavorian, Richard Grady, Paul A Merguerian
INTRODUCTION: Complete primary repair of bladder exstrophy (CPRE) is widely used for classic bladder exstrophy (CBE) closure. Long-term renal function with or without dilation in these patients is poorly characterized and may be impacted by bladder storage parameters or recurrent urinary tract infections (UTIs). OBJECTIVE: We sought to assess our long-term experience with CPRE and investigate factors that may influence upper-tract deterioration. STUDY DESIGN: A retrospective review of patients at our institution with CBE undergoing CPRE from 1990 to 2015 was performed...
May 17, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28579135/urinary-tract-infection-after-voiding-cystourethrogram
#18
E K Johnson, N R Malhotra, R Shannon, D L Jacobson, J Green, C K Rigsby, J L Holl, E Y Cheng
BACKGROUND: Reported rates of post-procedural urinary tract infection (ppUTI) after voiding cystourethrogram (VCUG) are highly variable (0-42%). OBJECTIVE: This study aimed to determine the risk of ppUTI after cystogram, and evaluate predictors of ppUTI. STUDY DESIGN: A retrospective cohort study of children undergoing VCUG or radionuclide cystogram (henceforth 'cystogram') was conducted. Children with neurogenic bladder who underwent cystogram in the operating room and without follow-up at the study institution were excluded...
May 25, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28555450/usefulness-of-parametric-renal-clearance-images-in-the-assessment-of-basic-risk-factors-for-renalnal-clearance-images-in-the-assessment-of-basic-risk-factors-for-renal-scarring-in-children-with-recurrent-urinary-tract-infections
#19
Ewa Pietrzak-Stelasiak, Małgorzata Bieńkiewicz, Wojciech Woźnicki, Krystyna Bubińska, Magdalena Kowalewska-Pietrzak, Anna Płachcińska, Jacek Kuśmierek
BACKGROUND: Clinically confirmed incidents of acute pyelonephritis (APN) following recurrent infections of urinary tract (UTI) form basic risk factors for renal scarring in children. Vesico-uretheral reflux (VUR) of higher grade is additional risk factor for this scarring. Opinions on diagnostic value of summed sequential images of renal uptake phase (SUM) of dynamic renal scintigraphy in detection of renal scars are diverse. However, several publications point to higher diagnostic efficacy of clearance parametric images (PAR) generated from this study...
2017: Nuclear Medicine Review. Central & Eastern Europe
https://www.readbyqxmd.com/read/28532765/prenatal-complicated-duplex-collecting-system-and-ureterocele-important-risk-factors-for-urinary-tract-infection
#20
Sofia Visuri, Timo Jahnukainen, Seppo Taskinen
PURPOSE: To evaluate the risk of urinary tract infections (UTIs) in infants with prenatally detected complicated duplex collecting system (CDS) or ureterocele. MATERIALS AND METHODS: All patients with prenatally detected CDS (n=34) or single system ureterocele (n=7) who were admitted to our institution between 2003 and 2013 were enrolled in this retrospective analysis. Duplex collecting systems with ureterocele (n=13), vesicoureteral reflux (VUR) (n=20) or nonrefluxing megaureter without ureterocele (n=7) were determined as complicated...
May 11, 2017: Journal of Pediatric Surgery
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