|
1
|
Leroy S, Romanello C, Smolkin V, Galetto-Lacour A, Korczowski B, Tuerlinckx D, Rodrigo C, Gajdos V, Moulin F, Pecile P, Halevy R, Gervaix A, Duhl B, Vander Borght T, Prat C, Foix-l'Hélias L, Altman DG, Gendrel D, Bréart G, Chalumeau M. Prediction of Moderate and High Grade Vesicoureteral Reflux After a First Febrile Urinary Tract Infection in Children: Construction and Internal Validation of a Clinical Decision Rule. J Urol 2012; 187:265-71. [PMID: 22100009 DOI: 10.1016/j.juro.2011.09.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Indexed: 11/26/2022]
Affiliation(s)
- Sandrine Leroy
- Center for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
- INSERM U953, Université Paris-Descartes, Paris, France
- Department of Pediatrics, Necker Hospital, AP-HP, Université Paris-Descartes, Paris, France
| | | | | | | | - Bartosz Korczowski
- Department of Pediatrics, Regional Hospital No. 2, University of Rzeszow, Rzeszow, Poland
| | - David Tuerlinckx
- Department of Pediatrics, Cliniques Universitaires de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Carlos Rodrigo
- Department of Pediatrics, Germans Trias i Pujol Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Vincent Gajdos
- INSERM U822, University Paris-Sud, Paris, France
- Department of Pediatrics, Antoine Béclère Hospital, Clamart, France
| | - Florence Moulin
- Department of Emergency Medicine, Saint-Vincent-de-Paul Hospital, AP-HP, Paris, France
| | - Paolo Pecile
- Department of Pediatrics, University of Udine, Udine, Italy
| | - Raphaël Halevy
- Department of Pediatrics, Ha'Emek Medical Center, Afula, Israel
| | - Alain Gervaix
- Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Barbara Duhl
- Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Thierry Vander Borght
- Department of Nuclear Medicine, Cliniques Universitaires de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - Cristina Prat
- Department of Microbiology, Germans Trias i Pujol Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | | | - Douglas G. Altman
- Center for Statistics in Medicine, University of Oxford, Oxford, United Kingdom
| | - Dominique Gendrel
- Department of Pediatrics, Necker Hospital, AP-HP, Université Paris-Descartes, Paris, France
| | - Gérard Bréart
- INSERM U953, Université Paris-Descartes, Paris, France
| | - Martin Chalumeau
- INSERM U953, Université Paris-Descartes, Paris, France
- Department of Pediatrics, Necker Hospital, AP-HP, Université Paris-Descartes, Paris, France
| |
Collapse
|
|
2
|
Abstract
Our aim was to assess the long-term outcomes of infants born out of a pregnancy complicated by unexplained polyhydramnios. We retrospectively analysed a cohort of 173 singleton pregnancies with polyhydramnios. There were 24 singletons with unexplained polyhydramnios, defined as polyhydramnios where prenatal testing was negative. Infants were examined by a paediatrician at a median age of 12 months (range 12-64 months). Of the 24 infants, 19 (79%) had a normal outcome. West syndrome, polyuria and pulmonary stenosis were diagnosed in three children during follow up, while there were two perinatal deaths. Paediatric follow up of children born out of pregnancies complicated by unexplained polyhydramnios should be carried out systematically.
Collapse
Affiliation(s)
- C Touboul
- Department of Obstetrics and Gynecology, Univ Paris-Sud, Hôpital Antoine Beclè, Clamart, France
| | | | | | | | | | | |
Collapse
|
|
3
|
Leroy S, Romanello C, Galetto-Lacour A, Smolkin V, Korczowski B, Rodrigo C, Tuerlinckx D, Gajdos V, Moulin F, Contardo M, Gervaix A, Halevy R, Duhl B, Prat C, Borght TV, Foix-l'Hélias L, Dubos F, Gendrel D, Bréart G, Chalumeau M. Procalcitonin to reduce the number of unnecessary cystographies in children with a urinary tract infection: a European validation study. J Pediatr 2007; 150:89-95. [PMID: 17188622 DOI: 10.1016/j.jpeds.2006.08.066] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Revised: 05/25/2006] [Accepted: 08/25/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To validate high serum procalcitonin (PCT) as a predictor of vesicoureteral reflux (VUR) in children with a first febrile urinary tract infection (UTI). STUDY DESIGN This secondary analysis of prospective hospital-based cohort studies included children ages 1 month to 4 years with a first febrile UTI. RESULTS Of the 398 patients included in 8 centers in 7 European countries, 25% had VUR. The median PCT concentration was significantly higher in children with VUR than in those without: 1.6 versus 0.7 ng/mL (P = 10(-4)). High PCT (> or =0.5 ng/mL) was associated with VUR (OR: 2.3; 95% CI, 1.3 to 3.9; P = 10(-3)). After adjustment for all cofactors, the association remained significant (OR: 2.5; 95% CI, 1.4 to 4.4; P = 10(-3)). The strength of the relation increased with the grade of reflux (P = 10(-5)). The sensitivity of procalcitonin was 75% (95% CI, 66 to 83) for all-grade VUR and 100% (95% CI, 81 to 100) for grade > or =4 VUR, both with 43% specificity (95% CI, 37 to 48). CONCLUSIONS High PCT is a strong, independent and now validated predictor of VUR that can be used to identify low-risk patients and thus avoid one third of the unnecessary cystourethrographies in children with a first febrile UTI.
Collapse
Affiliation(s)
- Sandrine Leroy
- Clinical Epidemiological Unit-Department of Pediatrics, Saint-Vincent-de-Paul Hospital, AP-HP, Université Paris-Descartes, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|