Novembre 2009 - Volume XXVIII - numero 9
Pagine elettroniche ; Ricerca
1Unità Operativa TIN, Ospedale Pugliese-Ciaccio, Catanzaro
2Dipartimento di Pediatria, Università “Magna Graecia”, Catanzaro
Indirizzo per corrispondenza: giusyd83@hotmail.it
Key words: Megaureter, Natural history, Children
Objectives - The purpose of our research was to assess the natural history of the non-refluxing, non-obstructive megaureter by means of a medium and long term follow-up. Methods - From 1992 to 2003 we observed 48 infants (37 males and 11 females) with a non-refluxing megaureter. In 58.3% of the cases it was already diagnosed through intrauterine ultrasound screening (US) during pregnancy, in 37.3% through neonatal ultrasound screening and in 4% because of urinary tract infection. In 43.7% of the cases the megaureter was on the left side, in 25% on the right side and it was bilateral in 31.3% on a total of 63 dilated units. All patients underwent: US, mintional cistouretrography (all negative for RVU), and renal dynamic scintigraphy. The scintigraphy showed that 81.2% of the patients did not have any obstruction and had a good and stable functionality, whereas in 16.6% the scintigraphic pattern resulted positive for obstruction but showed normal glomerular filtrate, except for 2.2%. Results - 80.4% of the children showed improvement, i.e. the reduction of 1st degree hydronephrosis; they were treated without surgery for an average period of 46.7 months (range 8-126, average 46). 19.6% of the cases underwent surgical treatment of re-implantation and re-modelling/refashioning: 7 patients because they had an obstructive megaureter and 2 patients since renal ultrasound showed a progressive dilation of the hydro-ureter-nephrosis. Conclusion - With our research we sustain that the treatment without surgery of the non-refluxing megaureter diagnosed during the prenatal period in asymptomatic newborn children is safe and effective.
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Pagine elettroniche ; Caso Contributivo
1Struttura Complessa di Pediatria, Ospedale SS. Annunziata, Taranto
2Clinica pediatrica “F. Vecchio”, Dipartimento di Biomedicina dell’Età Evolutiva, Policlinico, Bari
Indirizzo per corrispondenza: pediatriataranto@hotmail.it
Key words: Limb pain, Acute lymphoblastic leukemia, Bone marrow aspirate
Acute lymphoblastic leukemia is the most common malignancy diagnosed in children. We report the case of a female patient presenting with asthenia and limb pain when admitted to our Operative Unit of Pediatrics. Laboratory studies showed high levels of lactic dehydrogenase, erythrosedimentation velocity and C reactive protein. These findings were potentially confusing taking into account the apparent wellness of the patient. Based on the suspect of a possible lymphoproliferative disorder, bone marrow aspirate was performed and it revealed a complete invasion by lymphoblasts. We conclude that it is important to consider this diagnostic scenario when we take care of children presenting with few and aspecific symptoms, together with high inflammatory values and other indexes, but with an uneventful blood count.
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