Clinical Efficacy of a Top-down Approach for Children with a First Febrile Urinary Tract Infection

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The “Top-Down” Approach to the Evaluation of Children with Febrile Urinary Tract Infection

The evaluation of children presenting with urinary tract infection (UTI) has long entailed sonography and cystography to identify all urological abnormalities that might contribute to morbidity. The identification of vesicoureteral reflux (VUR) has been of primary concern since retrospective studies from the 1930s to 1960s established a strong association between VUR, recurrent UTI, and renal c...

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Top-down approach for evaluation of urinary tract infection.

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Procalcitonin as a predictor of vesicoureteral reflux in children with a first febrile urinary tract infection.

OBJECTIVE A first febrile urinary tract infection leads to the diagnosis of vesicoureteral reflux in 20% to 40% of children. Systematic voiding cystourethrography then is recommended. However, for 60% to 80% of the children, voiding cystourethrography is a posteriori normal. Moreover, it is irradiating, painful, and expensive. Thus, selective approaches are needed. Because procalcitonin has bee...

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Radiographic Evaluation of Children with Febrile Urinary Tract Infection: Bottom-Up, Top-Down, or None of the Above?

The proper algorithm for the radiographic evaluation of children with febrile urinary tract infection (FUTI) is hotly debated. Three studies are commonly administered: renal-bladder ultrasound (RUS), voiding cystourethrogram (VCUG), and dimercapto-succinic acid (DMSA) scan. However, the order in which these tests are obtained depends on the methodology followed: bottom-up or top-down. Each stra...

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The Relationship between Chronic Constipation and Urinary Tract Infection in Children: A Case-Control Clinical Study

  Background Urinary tract infection (UTI) is one of the most common bacterial infections in children, if not diagnosed leads to serious complications such as hypertension, chronic renal failure and renal scar. Constipation is one of the main risk factors for recurrent UTI. The aim of present study was to investigate the relationship between chronic constipation and urinary tract infection in c...

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ژورنال

عنوان ژورنال: Childhood Kidney Diseases

سال: 2017

ISSN: 2384-0242,2384-0250

DOI: 10.3339/jkspn.2017.21.2.114