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Background: We aimed to investigate the efficacy of postnatal ultrasonography in detecting congenital anomalies of the kidneys and urinary tract in term infants without prenatal history of congenital anomalies of the kidneys and urinary tract. Methods: In this retrospective cohort study, we reviewed the records of term infants between six weeks and three months of age who underwent urinary tract ultrasonography during routine pediatric care. Results: Congenital anomalies of the kidneys and urinary tract were detected on prenatal ultrasonography in 75 of the 2620 patients included in the study. Congenital anomalies of the kidneys and urinary tract were detected via postnatal USG in 46 (1.8%) of 2554 patients without anomalies on prenatal USG screening. The most common anomaly was hydronephrosis (69.6%). Thirty-two cases of hydronephrosis, three cases of renal agenesis, four cases of horseshoe kidney, one case of MCDK, and two cases of duplex systems which were not detected on prenatal USG were detected on postnatal USG. On the other hand, 29 (1.1%) cases with mild or moderate hydronephrosis on prenatal ultrasonography did not have hydronephrosis on postnatal ultrasonography. Conclusions: In our study, approximately one-third of the cases of hydronephrosis, unilateral renal agenesis, duplex systems, horseshoe kidney, and ectopic kidney were not detected in prenatal ultrasonography screening. Therefore, we believe that in addition to prenatal ultrasonography screening, postnatal ultrasonography screening of all children for urinary tract anomalies would be beneficial. [ABSTRACT FROM AUTHOR]

Background: Acute pyelonephritis (APN) can lead to renal scar formation, high blood pressure, and end-stage renal failure. Prompt and early diagnosis of APN is important for preventing future complications. Our goal was to study the mean platelet volume (MPV) as a predictor of APN in children. Methods: The records of 43 patients with APN and 51 patients with a lower urinary tract infection (UTI) were investigated prospectively. APN was confirmed using radioactive nuclide 99mTc-DMSA scanning. The white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), and MPV of both groups were measured and compared. Results: The WBC count, MPV and ESR values, and the serum concentration of CRP were higher in the APN group than in the lower UTI group ( p < 0.05). In the children with APN, the optimal cut-off value for the MPV was 8.2 fl [area under the curve (AUC): 0.906], with sensitivity of 81.4 % and specificity of 86.3 %. The MPV was associated with APN ( p = 0.001), and the sensitivity and specificity of the MPV for the diagnosis of APN were higher than those of the other inflammation markers. MPV > 8.2 fl yielded an adjusted OR of 7.8 (95 % CI 3.3-18.4, p < 0.001) for APN. MPV > 8.2 fl was significantly associated with late renal scar formation (adjusted OR 5.7, 95 % CI 2.3-13.8, p < 0.001). Conclusion: The MPV is a fast and reliable measurement with considerable predictive value for the diagnosis of APN and renal scars, and its predictive capacity is better than that of CRP, ESR, and WBC values. [ABSTRACT FROM AUTHOR]

Aim: We aimed to examine whether there is any association between serum levels of 25-hydroxyvitamin D [25(OH)D3] and urinary tract infection (UTI) among children. Methods: White blood cell count, serum C-reactive protein, calcium, phosphorus, alkaline phosphatase, parathormone, and serum 25(OH)D3 levels were measured in 82 children experiencing a first episode of UTI, with no risk factors for UTI, and 64 healthy control children. Results: The mean serum levels of 25(OH)D3 among children with UTI were significantly lower than those of controls (11.7 ± 3.3 vs. 27.6 ± 4.7 ng/ml; p < 0.001). The serum levels of 25(OH)D3 were significantly lower in patients with acute pyelonephritis compared to patients with lower UTI (8.6 ± 2.8 vs. 14.2 ± 3.0 ng/ml; p < 0.001). Within the study group, mean serum levels of 25(OH)D3 among girls were lower than those of boys (10.9 ± 3.4 ng/ml vs. 13.2 ± 4.4 ng/ml; p < 0.001). Multivariate analysis showed that a serum 25(OH)D3 level of <20 ng/ml (odds ratio 3.503, 95% confidence interval 1.621-7.571; p = 0.001) was associated with UTI in children. Conclusions: Our results suggest that vitamin D deficiency may be a risk factor for UTI in children. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To assess whether mean platelet volume (MPV) can be used as a marker in the differential diagnosis of periodic fever, aphthous stomatitis, pharyngitis, adenitis (PFAPA) syndrome. Methods: The leucocyte counts, thrombocyte counts, and MPV values of 57 children with PFAPA syndrome were recorded during an attack and an attack free period. These values were compared with a healthy control group of 55 individuals. Demographic features of the PFAPA patients group including age, gender and age of first attack, age at diagnosis, frequency of attacks, serum reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were also recorded. Results: The MPV values of the children with PFAPA both during an attack and attack free period were found significantly lower than the MPV values of healthy control group (p <0.001). Also, the MPV values of the children with PFAPA during an attack were significantly lower than in attack free periods (p <0.001). The MPV values showed no correlation with leucocytes counts, CRP, and ESR during attacks. A 8.30fl [area under the curve (AUC: 0.965)] optimal cutoff value of MPV with a sensitivity of 89.5% and specificity of 92.8% was determined during an attack in children with PFAPA. Conclusions: The MPV values during an attack and attack free period of patients with PFAPA is lower than in controls. The MPV values may be used as a marker in the differential diagnosis of PFAPA syndrome but more studies are needed and they should be prospective in order to validate this data. [Copyright &y& Elsevier]