Biomedical subjects

V Fanos

Publications and source records attributed to V Fanos.

80 records · Page 5Linked to original sources

PubMedDate not supplied

[Nutrition in chronic renal insufficiency in the first year of life].

In the first year of life, period of maximal anabolism, optimal metabolic and nutritional conditions are strictly required. In fact growth retardation of the infant is seldom recoverable in the following pediatric ages. Conservative management of chronic renal failure in the first year of life is essentially dietetic. Normal growth is warranted by adequate protein intake (6-8% of total calories) and optimal caloric support (> 75-80% of RDA). Water requirements (evaluated on the basis of diuresis, hydratation and weight variations) must be administrated during the whole 24-hours period to avoid dehydration. Sodium and potassium limitations are not generally indicated and only in advanced phases must be carefully evaluated. On the contrary, in early stages, a reduction of phosphorus intake and calcium and vitamin D supplementation are commonly suggested. Maternal milk is the nutritional gold standard during the first year of life. Hyposmolar formula with normal Na and low P content (Ca/P ratio = 1.4-2) and a protein content comprised between 1.4 and 1.8 g/100 ml represent the second choice.

Calcium↗

PubMedDate not supplied

[DRG and infections of the urinary tract in pediatrics].

The aim of this study was the evaluation of admissions in 1995 in the two public hospitals of Verona (Azienda Ospedaliera di Verona) ascribed to the DRG 322 (urinary tract infections from birth to 17 years). Seventy-six patients with actual diagnosis of urinary tract infection were evaluated. The coefficient of variation of hospitalization for the DRG 322 was 52%, attesting a good grade of internal homogeneity. A more detailed subdivision of the DRG 322 on the basis of age is required in pediatric patients.

Adolescent↗

PubMedDate not supplied

[Mortality from renal causes of death in an Italian population under 20 years of age in the 1979-1991 period].

The present paper addresses mortality from urinary diseases (ICD9 codes 580-599) in the Italian pediatric population aged 0-19 years, in the period 1979-91. Mortality data were obtained from the Italian National Statistical Institute (ISTAT). A total number of 522 deaths were recorded among people aged 0-19 years, amounting to 0.33% of all casualties. Half of these deaths were due to renal failure (ICD9 codes: 584-586). While mortality from all causes decreased by 35% among the Italian pediatric population, mortality from urinary diseases remained stable during the same period, and even increased in the age range 0-4 years (from 3.47 per million person-years in 1979 to 9.83 per million person-years in 1990; p < 0.001). This outbreak in mortality was entirely due to an increase in casualties from acute renal failure (ICD9 code: 584). In conclusion, since the increase in mortality from urinary diseases among Italian children aged 0-4 years takes place in the presence of a substantial drop in mortality from all causes, attention should be paid to this problem and surveillance systems should be reinforced.

Adolescent↗

PubMedDate not supplied

[Pilot studies on the effect of desmopressin on the personality of enuretic children].

The aim of this paper was to establish if there is a correlation between desmopressin administration and modification of psychological experience in enuretic children. 22 enuretic children (18 treated with desmopressin, 4 not treated) were enrolled in the study. They underwent a complete psychological examination, differentiated on the basis of chronological age, before the beginning and at the end of the treatment (duration 4 months). The psychologist was not informed if they were treated or not. In the 17 of 18 treated children with basal psychological problems, 14 became normal, 2 demonstrated a significative amelioration and 1 remained pathologic at the end of the treatment. No modification was observed in not treated patients, all presenting psychological problems. 6 emblematic cases with psychological findings and paintings are presented. The results seem interesting, despite the low number of children enrolled.

Adolescent↗

PubMedDate not supplied

[Glycopeptides and the newborn infant's kidney].

The aim of this paper was to evaluate glycopeptide nephrotoxicity in the newborn. The exact mechanism of nephrotoxicity has not been defined. Basal mechanism of vancomycin nephrotoxicity seems related to the energy-dependent tubular transport of the drug from blood to tubular cell across the basolateral membrane. Moreover a tubular reabsorption is probably involved, but it is not relevant for nephrotoxicity. Considering the widespread use of this antibiotic, the question of nephrotoxic side effects in humans is of great importance. However, the results of studies published to date are controversial. Results differ considerably depending on the period considered and on the sensitivity of the methods used to indicate renal damage. In paediatric patients (including neonates) the nephrotoxicity of vancomycin appears to be less than that in adults, thus confirming a number of experimental observations. It is commonly suggested that pharmacokinetic monitoring of doses in children should minimize nephrotoxicity. The most important risk factors for the development of the nephrotoxic action of vancomycin are: pre-dose values > 10 mg/l, prolonged therapy (> 21 days), and concomitant treatment with aminoglycosides. In most cases nephrotoxicity associated with vancomycin is reversible, even after high doses. In conclusion it could be speculated that vancomycin nephrotoxicity relates to the combined effect of a large area under the concentration-time curve and duration of therapy. Teicoplanin is a new glycopeptide that is effective in the treatment of both children and neonates and offers the advantages of once daily administration, choice of administration route (intramuscular or rapid intravenous bolus) and lack of requirement for routine therapeutic drug monitoring. Finally it seems less nephrotoxic than vancomycin. In the neonatal age bracket, none of the 173 patients treated presented abnormalities of traditional kidney function parameters.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Microscopic hematuria in children].

Hematuria is a common finding on a urinalysis, with a prevalence rate between 1% and 2%. The execution of screening of hematuria in children is controversial. Once hematuria has been identified, it is useful to identify sources of bleeding, as either glomerular or non-glomerular. If microscopic hematuria is confirmed, investigations would include: hypercalciuria screen, blood examinations (full blood count, renal function tests, complement and autoantibody screen), renal tract ultrasound, urinalysis of family members, audiogram, if family history of deafness is present, or family members present a positive dipstick. If all these tests are negative and microscopic hematuria persists, then a renal biopsy is advocated.

Child↗

PubMedDate not supplied

[Renal polycystosis in pediatrics].

Inherited polycystic kidney disease (PKD) in children is a disorder characterized by diffuse cystic involvement of both kidneys, without evidence of dysplasia. Both forms, autosomal recessive (ARPKD) and autosomal dominant (ADPKD) have considerable overlap in clinical presentation and radiographic features in the pediatric population. At present, a prenatal diagnosis is possible with ultrasound examination. A brief review of the literature is here reported. The knowledge of pathophysiological and clinical data is requested, since PKD represents a major cause of renal failure in pediatrics.

Child↗

PubMedDate not supplied

[Vesico-ureteral reflux in pediatrics].

Vesico-ureteral reflux (VUR) is the most frequent uropathy involving 1-2% of children. Genetics, familiarity, race gender and age intervene in the pathogenesis of VUR. In particular, neonatal VUR seems to represent a specific entity. Different factors determine a renal damage due to RVU: direct action of VUR (back pression), urinary tract infection (UTI), inflammatory mechanisms and renal dysplasia. Micturing cystourethrography and nuclear cystography are currently performed for the diagnosis of VUR, being ultrasound examination aspecific. Functional parameters are now investigated in association with new morphologic studies. The strict relationship of VUR and UTI is discussed. The treatment (medical, surgical) of VUR is not well established, although some guidelines can be suggested. Finally an adequate support must be given to the family for an optimal management.

Female↗