SPECIFIC FEATURES OF ENDOSCOPIC CORRECTION TECHNIQUE OF VESICOURETERAL REFLUX IN CHILDREN

2021 ◽  
Vol 100 (4) ◽  
pp. 87-92
Author(s):  
S.N. Zorkin ◽  
◽  
D.S. Shakhnovsky ◽  
E.R. Barsegyan ◽  
B.N. Uvarov ◽  
...  
Keyword(s):  
Vesicoureteral Reflux ◽  
Treatment Options ◽  
Reflux Nephropathy ◽  
Correct Choice ◽  
Bulking Agents ◽  
Ureteral Orifice ◽  
Correction Technique ◽  
Increased Risk ◽  
Endoscopic Correction ◽  
The 19Th Century

Vesicoureteral reflux (VUR) is one of the most frequent diseases in pediatric urology studied since the 19th century. It has an increased risk of infection of the urinary tract, sclerosis of the renal parenchyma and development of reflux-nephropathy with an outcome in renal failure. Several treatment options have been developed for patients with VUR. For 50 years, open ureteral reimplantation has been considered the «gold standard» of treatment, but over the past 20 years there has been a shift towards less invasive methods, primarily endoscopic administration of bulking agents. In order to increase the effectiveness of endoscopic treatment, several basic recommendations for the operation have been identified and many volume-forming drugs have been developed. The most important is the correct choice of one of the three main methods of drug administration and the hydrodilation of the ureteral orifice during injection. Performing of endoscopic correction in compliance with all the rules and the use of the latest generation of bulking agents ensure the frequency of elimination of VUR up to 90% after the first injection.

scholarly journals Possibilities of endoscopic treatment of primary vesicoureteral reflux

2004 ◽  
Vol 57 (3-4) ◽  
pp. 159-163 ◽  
Author(s):  
Jan Varga ◽  
Dragana Zivkovic ◽  
Dusanka Dobanovacki ◽  
Slobodan Petrovic
Keyword(s):  
Vesicoureteral Reflux ◽  
Endoscopic Treatment ◽  
Urinary Infection ◽  
Reflux Nephropathy ◽  
First Grade ◽  
Fifth Grade ◽  
Safe Procedure ◽  
Pediatric Practice ◽  
Endoscopic Correction ◽  
Primary Vesicoureteral Reflux

Introduction Vesicoureteral reflux, urinary infection and pyelonephritic scarring represent a well known triad in pediatric practice that may lead to severe scarring of kidneys, and development of so called reflux nephropathy. Apart from standard therapeutic options (conservative treatment and surgical therapy), endoscopic correction of refluxing vesicoureteral junction has been introduced into clinical practice. Material and methods This study included endoscopically treated patients with primary vesicoureteral reflux over a 9-year period, as well as certain clinical parameters. Results Endoscopic correction of primary vesicoureteral reflux with teflon paste has been successful in up to 93.5% of patients. After one application vesicoureteral reflux disappeared in 58.8% of cases. After two applications 86.0% of ureters were cured, whereas the third application had no further effect on existing reflux. Improvement with spontaneous regression of reflux was established in 7.5% of treated ureters. Discussion Endoscopic correction should be performed in all patients with third grade vesicoureteral reflux, and in selected patients with second and fourth grade reflux. First grade reflux should be treated conservatively, and fifth grade reflux should be treated surgically. Conclusion Endoscopic treatment of primary vesicoureteral reflux is an easy, simple, fast and safe procedure that prevents regurgitation of urine from bladder to upper parts of the urinary system in most of cases.

scholarly journals Vesicoureteral Reflux, Reflux Nephropathy, and End-Stage Renal Disease

2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
Author(s):  
Paul Brakeman
Keyword(s):  
Renal Disease ◽  
Vesicoureteral Reflux ◽  
End Stage Renal Disease ◽  
Reflux Nephropathy ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Data Source ◽  
Stage Renal Disease ◽  
End Stage ◽  
Published Research

Objective. To review the contribution of vesicoureteral reflux and reflux nephropathy to end-stage renal disease.Data Source. Published research articles and publicly available registries.Results. Vesicoureteral reflux (VUR) is commonly identified in pediatric patients and can be associated with reflux nephropathy (RN), chronic kidney disease (CKD), and rarely end-stage renal disease (ESRD). Patients with reduced GFR, bilateral disease, grade V VUR, proteinuria, and hypertension are more likely to progress to CKD and ESRD. Because progression to ESRD is rare in VUR and often requires many decades to develop, there are limited prospective, randomized, controlled trials available to direct therapy to prevent progression to ESRD.Conclusions. Identification of patients with increased risk of progression to CKD and ESRD should be the goal of clinical, biochemical, and radiological evaluation of patients with VUR. Treatment of patients with VUR should be directed at preventing new renal injury and preserving renal function.

181: Ordinary Glass Sphere as an Alternative Injectable Material for Endoscopic Correction of Vesicoureteral Reflux

2004 ◽  
Vol 171 (4S) ◽  
pp. 48-48
Author(s):  
Ferruh Simsek ◽  
Selcuk Yucel ◽  
Mustafa Aktas ◽  
Levent N. Turkeri
Keyword(s):  
Vesicoureteral Reflux ◽  
Glass Sphere ◽  
Endoscopic Correction

scholarly journals Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  
Keyword(s):  
Case Report ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Female Child ◽  
Correct Choice ◽  
Blood Cultures ◽  
Microbial Culture ◽  
Acinetobacter Baumanii ◽  
Inappropriate Use ◽  
History Of

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

scholarly journals Ethnic Disparities in the Development of Sight-Threatening Diabetic Retinopathy in a UK Multi-Ethnic Population with Diabetes: An Observational Cohort Study

2021 ◽  
Vol 11 (8) ◽  
pp. 740
Author(s):  
Manjula D. Nugawela ◽  
Sarega Gurudas ◽  
Andrew Toby Prevost ◽  
Rohini Mathur ◽  
John Robson ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Ethnic Differences ◽  
Minority Groups ◽  
Treatment Options ◽  
Ethnic Disparities ◽  
Ethnic Minority Groups ◽  
The United Kingdom ◽  
Increased Risk ◽  
Observational Cohort ◽  
General Practices

There is little data on ethnic differences in incidence of DR and sight threatening DR (STDR) in the United Kingdom. We aimed to determine ethnic differences in the development of DR and STDR and to identify risk factors of DR and STDR in people with incident or prevalent type II diabetes (T2DM). We used electronic primary care medical records of people registered with 134 general practices in East London during the period from January 2007–January 2017. There were 58,216 people with T2DM eligible to be included in the study. Among people with newly diagnosed T2DM, Indian, Pakistani and African ethnic groups showed an increased risk of DR with Africans having highest risk of STDR compared to White ethnic groups (HR: 1.36 95% CI 1.02–1.83). Among those with prevalent T2DM, Indian, Pakistani, Bangladeshi and Caribbean ethnic groups showed increased risk of DR and STDR with Indian having the highest risk of any DR (HR: 1.24 95% CI 1.16–1.32) and STDR (HR: 1.38 95% CI 1.17–1.63) compared with Whites after adjusting for all covariates considered. It is important to optimise prevention, screening and treatment options in these ethnic minority groups to avoid health inequalities in diabetes eye care.

scholarly journals Urinary Excretion of Phenolic Acids by Infants and Children: A Randomised Double-Blind Clinical Assay

2012 ◽  
Vol 6 ◽  
pp. CMPed.S9349
Author(s):  
J. Uberos ◽  
V. Fernéndez-Puentes ◽  
M. Molina-Oya ◽  
R. Rodrïguez-Belmonte ◽  
A. Ruïz-López ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Ferulic Acid ◽  
Phenolic Acids ◽  
Treatment Options ◽  
Randomised Clinical Trial ◽  
Phase Iii ◽  
Double Blind ◽  
Clinical Assay ◽  
Increased Risk ◽  
Study Population

Objectives The present study, which is part of the ISRCTN16968287 clinical assay, is aimed at determining the effects of cranberry syrup or trimethoprim treatment for UTI. Methods This Phase III randomised clinical trial was conducted at the San Cecilio Clinical Hospital (Granada, Spain) with a study population of 192 patients, aged between 1 month and 13 years. Criteria for inclusion were a background of recurrent UTI, associated or otherwise with vesico-ureteral reflux of any degree, or renal pelvic dilatation associated with urinary infection. Each child was randomly given 0.2 mL/Kg/day of either cranberry syrup or trimethoprim (8 mg/mL). The primary and secondary objectives, respectively, were to determine the risk of UTI and the levels of phenolic acids in urine associated with each intervention. Results With respect to UTI, the cranberry treatment was non-inferior to trimethoprim. Increased urinary excretion of ferulic acid was associated with a greater risk of UTI developing in infants aged under 1 year (RR 1.06; CI 95% 1.024–1.1; P = 0.001). Conclusions The results obtained show the excretion of ferulic acid is higher in infants aged under 1 year, giving rise to an increased risk of UTI, for both treatment options.

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