Database: Ovid MEDLINE(R) <1950 to March Week 3 2010>
Search Strategy:
-------------------------------------------------------------------------------1 *pyelonephritis/dt, th, su, rt (1213)
2 acute disease/ or acute.tw. (681692)
3 pyelonephritis/co (2235)
4 1 and 2 and 3 (40)
5 pyelonephritis/dt, th, su, rt (2922)
6 5 and 3 and 2 (101)
7 limit 6 to (english language and male and "all infant (birth to 23 months)") (3)
8 from 7 keep 1-3 (3)
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<1>
Unique Identifier
18551321
Status
MEDLINE
Authors
Sharifian M. Anvaripour N. Karimi A. Fahimzad A. Mohkam M. Dalirani R. Gholikhani F.
Rafiee MA.
Authors Full Name
Sharifian, Mostafa. Anvaripour, Navid. Karimi, Abdollah. Fahimzad, Alireza. Mohkam,
Masoomeh. Dalirani, Reza. Gholikhani, Fatemeh. Rafiee, Mohammad Ali.
Institution
Department of Nephrology, Mofid Children's Hospital, Shariati Ave, Tehran, Iran.
mostafasharifian@yahoo.com
Title
The role of dexamethasone on decreasing urinary cytokines in children with acute
pyelonephritis.
Source
Pediatric Nephrology. 23(9):1511-6, 2008 Sep.
Abstract
Cytokines play a major role in renal scar formation following febrile urinary tract infection
(UTI). We investigated the role of dexamethasone combined with antibiotics in diminishing
urinary interleukin-6 (UIL-6) and UIL-8 concentrations during the acute phase of pyelonephritis
compared with standard antibiotic therapy. UIL-6 and UIL-8 concentrations were determined by
enzyme immunoassay in 34 children with pyelonephritis who were treated with ceftriaxone plus
dexamethasone (case group) and in 20 patients with the same diagnosis treated with ceftriaxone
alone (control group). Urine samples were obtained at the time of presentation prior to drug
administration and at follow-up 72 h after initiation of medication. Creatinine concentrations
were also determined, and cytokine/creatinine ratios were calculated to standardize samples.
Differences between cytokine/creatinine ratios in initial and follow-up urine samples were
significant in the case group (P < 0.001) but not for controls. In addition, combined antibiotic and
dexamethasone significantly decreased UIL-6 and UIL-8 concentrations compared with
antibiotic alone (P < 0.05). We conclude that dexamethasone combined with antibiotics
significantly decreases UIL-6 and UIL-8 levels in patients with acute pyelonephritis. This
suggests that the clinical use of corticosteroids may prevent scar formation following febrile UTI.
Publication Type
Journal Article.
<2>
Unique Identifier
11207174
Status
MEDLINE
Authors
Benador D. Neuhaus TJ. Papazyan JP. Willi UV. Engel-Bicik I. Nadal D. Slosman D.
Mermillod B. Girardin E.
Authors Full Name
Benador, D. Neuhaus, T J. Papazyan, J P. Willi, U V. Engel-Bicik, I. Nadal, D. Slosman, D.
Mermillod, B. Girardin, E.
Institution
Department of Paediatrics, Cantonal University Hospital, 6 rue Willy Donze, 1211 Geneva 14,
Switzerland. benador@bluewin.ch
Title
Randomised controlled trial of three day versus 10 day intravenous antibiotics in acute
pyelonephritis: effect on renal scarring.
Source
Archives of Disease in Childhood. 84(3):241-6, 2001 Mar.
Other ID
Source: NLM. PMC1718672
Abstract
BACKGROUND: Acute pyelonephritis often leaves children with permanent renal scarring.
AIMS: To compare the prevalence of scarring following initial treatment with antibiotics
administered intravenously for 10 or three days. METHODS: In a prospective two centre trial,
220 patients aged 3 months to 16 years with positive urine culture and acute renal lesions on
initial DMSA scintigraphy, were randomly assigned to receive intravenous ceftriaxone (50 mg/kg
once daily) for 10 or three days, followed by oral cefixime (4 mg/kg twice daily) to complete a 15
day course. After three months, scintigraphy was repeated in order to diagnose renal scars.
RESULTS: Renal scarring developed in 33% of the 110 children in the 10 day intravenous group
and 36% of the 110 children in the three day group. Children older than 1 year had more renal
scarring than infants (42% (54/129) and 24% (22/91), respectively). After adjustment for age,
sex, duration of fever before treatment, degree of inflammation, presence of vesicoureteric reflux,
and the patients' recruitment centres, there was no significant difference between the two
treatments on renal scarring. During follow up, 15 children had recurrence of urinary infection
with no significant difference between the two treatment groups. CONCLUSION: In children
with acute pyelonephritis, initial intravenous treatment for 10 days, compared with three days,
does not significantly reduce the development of renal scarring.
Publication Type
Clinical Trial. Comparative Study. Journal Article. Multicenter Study. Randomized
Controlled Trial.
<3>
Unique Identifier
2685219
Status
MEDLINE
Authors
de Man P. Claeson I. Johanson IM. Jodal U. Svanborg Eden C.
Authors Full Name
de Man, P. Claeson, I. Johanson, I M. Jodal, U. Svanborg Eden, C.
Institution
Department of Clinical Immunology, University of Goteborg, Sweden.
Title
Bacterial attachment as a predictor of renal abnormalities in boys with urinary tract infection.
Source
Journal of Pediatrics. 115(6):915-22, 1989 Dec.
Abstract
The development of renal scarring was analyzed prospectively in 241 boys with their first
known episode of symptomatic urinary tract infection (140 acute pyelonephritis, 61 acute cystitis,
and 40 nonspecific). Of 197 boys undergoing urography, 22 (11%) had scars; 20 were in the
pyelonephritis group. Vesicoureteral reflux occurred in 81% of those with scarring, compared
with 20% of those without scarring. The bacteria causing the first episode of urinary tract
infection in each patient were saved, and Escherichia coli organisms were characterized for the
expression of both galactose-alpha (1----4)galactose-beta (Gal-Gal)-specific adhesins and pap
homologous DNA. Scarring occurred in 41% and other renal abnormalities in 11% of boys
infected with bacteria that did not bind Gal-Gal (Gal-Gal negative), compared with 5% and 1%,
respectively, in those infected with Gal-Gal-binding strains (Gal-Gal-positive) (relative risk 8.3;
95% confidence limits 3.3 to 20.4; p less than 0.001). That boys infected with Gal-Gal-negative
strains more often had reflux did not explain the increased risk for renal scarring in this group.
The possibility that the phenotypically negative strains could be induced to express Gal-Gal
adhesions in vivo was excluded by dot blot analysis, which showed the absence of pap
homologous DNA in all but one of the Gal-Gal-negative strains. The results suggest that the
absence of Gal-Gal-specific adhesins in E. coli can be used as an indicator of risk for renal
scarring and the need for radiologic examination.
Publication Type
Journal Article. Research Support, Non-U.S. Gov't.