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Ammenti A.,University of Parma | Cataldi L.,Catholic University Sacro Cuore | Chimenz R.,Messina University | Fanos V.,University of Cagliari | And 9 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2012

We report the recommendations for the diagnosis, treatment, imaging evaluation and use of antibiotic prophylaxis in children with the first febrile urinary tract infection, aged 2 months to 3 years. They were prepared by a working group of the Italian Society of Pediatric Nephrology after careful review of the available literature and a consensus decision, when clear evidence was not available. Conclusion: These recommendations are endorsed by the Italian Society of Pediatric Nephrology. They can also be a tool of comparison with other existing guidelines in issues in which much controversy still exists. © 2011 The Author(s)/Acta Pædiatrica. Source

Smith F.G.,Institute for Child and Maternal Health | Smith F.G.,University of Calgary | Fewell J.E.,Institute for Child and Maternal Health | Fewell J.E.,University of Calgary | And 2 more authors.
Clinical and Experimental Pharmacology and Physiology | Year: 2011

1. Core temperature (Tc), cardiovascular and renal responses to lipopolysaccharide (LPS), as well as the role of endogenously produced prostaglandins (PG) in influencing these responses, were investigated in the present study in conscious, chronically instrumented lambs. 2. Core temperature, mean arterial pressure, heart rate (HR), renal blood flow (RBF) and several parameters of renal function were measured for 30min before and for 5h after intravenous injection of 0.03μg/kg of the LPS Salmonella abortus equi (n=9) or saline vehicle (n=9). 3. After injection of LPS, Tc increased with a latency of 40min, duration of 130min and magnitude of 1.5°C. Mean arterial pressure increased within 110min of LPS injection and then decreased below baseline within 5h, concomitant with an increase in HR. There was a sustained increase in RBF after LPS injection and a significant increase in urinary flow rate, as well as Na + and Cl - excretion. 4. To determine the role of PGs in the responses to LPS observed, additional experiments were performed in another group of conscious lambs that had been pretreated with the non-selective cyclo-oxygenase inhibitor indomethacin (10mg/kg; n=6). 5. Although indomethacin abolished the Tc response to LPS, it had no significant effect on the cardiovascular and renal responses to LPS. There were no effects of saline vehicle on any of the variables measured. 6. These data provide evidence that, in conscious young lambs, cardiovascular and renal responses to LPS do not appear to be mediated by endogenously produced PGs and that they are independent of pyrogen-induced changes in Tc. © 2011 The Authors. Clinical and Experimental Pharmacology and Physiology © 2011 Blackwell Publishing Asia Pty Ltd. Source

Pennesi M.,Institute for Child and Maternal Health | L'Erario I.,Institute for Child and Maternal Health | Travan L.,Institute for Child and Maternal Health | Ventura A.,Institute for Child and Maternal Health
Pediatric Nephrology | Year: 2012

Background Recent guidelines on urinary tract infection (UTI) agree on reducing the number of invasive procedures. None of these has been validated by a long-term study. We describe our 11-years experience in the application of a diagnostic protocol that uses a reduced number of invasive procedures. Methods We reviewed retrospectively the records of 406 children aged between 1 and 36 months at their first UTI. All patients underwent renal ultrasound (RUS). Children with abnormal RUS and those with UTI recurrences underwent voiding cystourethrography (VCUG) and dimercaptosuccinic acid (DMSA) renal scans. Results RUS after the first UTI was pathological in 7.4% children; 4.4 % had a second UTI.We performed 48 VCUG: 14 patients (29%) had vesicoureteral reflux (VUR), 12 of which showed an abnormal RUS while 2 had recurrent UTI. After DMSA renal scan renal damage appeared in only 6 of them (12.5%); all these children showed grade IV VUR. Conclusions The application of our guidelines leads to a decrease in invasive examinations without missing any useful diagnoses or compromising the child's health. © IPNA 2011. Source

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