Risk factors in the development of early technetium-99m dimercaptosuccinic acid renal scintigraphy lesions during first urinary tract infection in children.

AIM: To establish the variables that correlate with uptake defects in dimercaptosuccinic acid (DMSA) scintigraphy performed in the acute phase of a first episode of urinary tract infection (UTI). METHODS: A prospective observational study was conducted in a cohort of 158 consecutive children with a first episode of symptomatic UTI. The therapeutic delay time (TDT) was recorded. DMSA scintigraphy was performed in all children and voiding cystourethrography in 150 of them. RESULTS: 85% of the patients were younger than 2 y. Mean TDT was 33.5 h. The aetiological agent was Escherichia coli in 140 children. DMSA scintigraphy was normal in 81. Vesicoureteric reflux was detected in 33. After a multivariate logistic regression analysis the following variables were retained in the final model: TDT > or = 48 h, growth of bacteria other than E. coli, percentage of polymorphonuclear cells > or = 60% and C-reactive protein > or = 30 mg l(-1). CONCLUSION: TDT > or = 48 h, bacteria other than E. coli, percentage of polymorphonuclear cells > or = 60% and CRP > or = 30 mg l(-1) influence the findings detected in the DMSA scintigraphy performed in the acute phase of a first episode of UTI.

[The value of C-reactive protein in the diagnosis of acute pneumopathies in children]. / Valor de la proteína C reactiva en el diagnóstico de las neumopatías agudas de la infancia.

We have studied 164 children with pneumopathy, ranging from one month to 8 years old. They were classified in two groups according as clinical, biological and radiological criteria. Group I (probable bacterial etiology), 65 children; group II (presumable nonbacterial cause), 35 patients. An indeterminate pattern, 64 infants. The CRP was quantified by radial immunodiffusion method. In the group II, lowest CRP values (less than 30 micrograms/ml) were detected in 86% of the patients. In the group I, 88% of the cases offered values over 30 micrograms/ml. The CRP was a sensitive indicator of diagnosis of pneumopathies in children. High CRP values (greater than 30 micrograms/ml) are suggestive of a bacterial etiology, with statistical significance (p less than 0,001).

[Diagnostic value of C reactive protein in neonatal sepsis (author's transl)]. / Valor diagnóstico de la proteína C reactiva en la sepsis neonatal.

Seric levels of C reactive protein (C.R.P.) were determined in a series of 125 children under one month old. Of them, 75 were clinically healthy and 50 showed signs that suggested infection. In all this infants, in addition to C.R.P., different components of white blood cell differential count were determined, and a bacteriological study was undergone. Authors found high concentration of C.R.P. in 100% of children in which diagnosis of sepsis was bacteriologically confirmed. On the other hand, concentrations of this biological parameter were not substantially modified in newborns used in the control, nor in those other ones in which sepsis was not confirmed. Sensibility of C.R.P. showed itself significantly higher than other hematological indexes in study.

[C reactive protein as a standard of efficience in antiinfectious therapy (author's transl)]. / Utilidad de la proteína C reactiva como parámetro de eficacia terapéutica antiinfecciosa.

C reactive protein (CRP) levels are sequencially settled in 58 children, divided in three groups in dependence of their illness: acute bacterial pneumopathy, acute pyelonephritis or neonatal sepsis, all of them receiving antibiotic treatment. CRP values are compared with clinical, radiologic and bacteriologic findings, showing in patients of the first two groups a normalization between fourth and ninth day of treatment, together with clinical and radiologic improvement. In contrast, it was shown that normalization of CRP in neonatal sepsis group was quite slow related to the torpid evolution. The sequentially measure of CRP was prove useful as antibiotic treatment control in children affected with different infectious pictures.

[Familial vesicoureteral reflux (author's transl)]. / Reflujo vesicoureteral familiar.

Sixteen members of three families, eight of which had vesicoureteral reflux, are studied. Authors report a high incidence in females (7 cases) and atrophic chronic pyelonephritis (75% of the serie). Only one girl presented disminution of renal function. The types of inheritance was dominant autosomal in the A family and autosomal recessive in the B and C families. Finally the norms of investigation of the familial vesicoureteral reflux are appointed.

[Value of the C reactive protein, urinary lactic dehydrogenase and renal capacity of concentration in the topographic diagnosis of the urinary infection in infancy (author's transl)]. / Valor de la proteína C reactiva, láctilo-dehidrogenasa urinaria y capacidad renal de concentración en el diagnóstico topográfico de la infección urinaria en la infancia.

In 39 children with urinary infection renal capacity of concentration, serum C-reactive protein and presence of urinary lactic dehydrogenase are studied pointing to the establishment of the topography of the damage. C-reactive protein levels higher than 20 micrograms/ml are 100 per 100 reliable in the diagnosis of pyelonephritis. Moreover, value of this test is confirmed as a guide of therapeutic efficacity. Difficulty of concentrating urine above 800 mOsm/l is 70 per 100 reliable and is a useful method for demonstrating parenchymal damage. The urinary lactic dehydrogenase was superior to 20 units/l in 64 per 100 of the cases, but other studies are necessary for interpretation of these data. These findings are similar to those obtained in the study of the isoenzymes.

[Uric nephropathy in malignant hemopaties: three cases with conserved diuresis (author's transl)]. / Nefropatía úrica en hemopatías malignas. Tres casos con diuresis conservada

Three observations of acute hyperuricemic renal insufficiency with conserved diuresis appeared during the course of a citostatic treatment of a lymphoblastic acute leukemia and two lymphoblastic lymphosarcomas are studied. The evolution of nephropathy was favourable in all cases by means of allopurinol and fluidtherapy.