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Brno, Czech Republic

Aim: Ultrasound investigation and voiding cystouretrography (VCUG) are part of the diagnostic algorithm in children with febrile urinary tract infection (UTI) with the aim of depicting any complication of the infection and underlying anomalies of the urinary tract. As the understanding of the relationship between UTI, renal scarring and vesicoureteral reflux (VUR) evolves, new recommended imaging algorithms are being introduced. Methods: 184 patients that underwent VCUG after the first or recurrent febrile UTI were included in the study. The incidence of VUR in both groups have been evaluated and compared with ultrasound findings. Patients with VUR were divided into those with non-dilating (VUR grade I-II) and dilating (VUR grade III-V) reflux. Results: Overall VUR was diagnosed in 39/184 (21%) patients. VUR was seen in 23/156 (15%) patients in the group of patients after the first fibrile UTI, in comparison to 16/28 (57%) patients with recurrent fibrile UTI (statistically significant difference, p < 0,0001). 8/156 (5%) patients after the first febrile UTI had dilating VUR, compared to 11/28 (39%) patients after recurrent febrile UTI (statistically significant difference, p < 0,0001). Conclusion. In compliance with current recommendations of the American Academy of Paediatrics the results of this study have shown low incidence of VUR and dilating VUR in patients with a history of single febrile UTI. Based on the results of our study it can be concluded that VCUG is not recommended in all patiens in the age of 2-24 months but only in specifically identified cases. Source


Prochazkova D.,Pediatricka klinika
Cesko-Slovenska Pediatrie | Year: 2010

Phenylketonuria (PKU) is a hereditary disease in the metabolism of the phenylalanine aminoacid, caused by a deficit of phenylalanine hydroxylase in liver. Patients with PKU must maintain an all-life low protein diet with low phenylalanine content in food in the aim to prevent neurological damage. Adherence to the diet is often low due to bad organoleptic properties of the mixtures of aminoacids without phenylalanine as well as the low protein products. The progress in biochemistry, genetics and especially molecular genetics recently resulted in changes of therapeutic strategy in patients with PKU. The present paper discusses the low protein diet, neutral long chain aminoacids, DHA and EPA, therapeutic postnatal repopulation of liver cells, tratrahydrobiopterin, enzyme replacement therapy by means of phenylalanine ammonia lyase (PAL) and gene therapy as a possible treatment of PKU. Source


Mitrova K.,Pediatricka klinika
Pediatrie pro Praxi | Year: 2012

Inflammatory bowel disease (IBD) is a group of chronic, immune-mediated diseases primarily affecting the gastrointestinal tract. IBD includes Crohn's disease, ulcerative colitis and indeterminate colitis. IBD can be painful and debilitating disease affecting child's nutritional status. Early diagnosis and optimal therapy can significantly change the course of the disease and ensure optimal child's growth and development. Source


The first year of infant's life is characterised by transition from liquid food, ideally breastfeeding, to solid type of foods. In the early period the infant nutrition is affected by the prenatal period and complications of its course. Important role may play inborn defects and metabolic disorders. Nevertheless there is an important role of parent's approach to pediatrician's advice. The most common problems related to nutrition in the early period are vomiting, flatulence, failure to thrive and diarrhea. It is possible to solve these symptoms promoting good clinical examination of the infant after having asked the detailed history and while respecting expert's recommendation. The crucial role of first line healthcare service is to separate the minor difficulties from situations that require intervention of a specialist. Source


Sumnik Z.,Pediatricka klinika
Pediatrie pro Praxi | Year: 2013

The aim of this article is to present the overview about basic developments in pediatric diabetes in several years. The paper included following topics: 1. Changes in epidemiological characteristics in childhood diabetes, 2. Prediction of type 1 diabetes (T1D), 3. Possibilities of prevention T1D, 4. Update on diagnostics of diabetes, 5. New criteria of diabetes control in children, 6. Differential diagnostics of diabetes, and 7. Diabetes technology news. Source

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