👉Urinary tract infections in children
📌Urinary tract infections (UTIs) in children are among the most common bacterial infections in childhood. They are equally common in boys and girls during the first year of life and become more common in girls after the first year of life. Dividing UTIs into three categories; febrile upper UTI (acute pyelonephritis), lower UTI (cystitis), and asymptomatic bacteriuria, is useful for numerous reasons, mainly because it helps to understand the pathophysiology of the infection. A single episode of febrile UTI is often caused by a virulent Escherichia coli strain, whereas recurrent infections and asymptomatic bacteriuria commonly result from urinary tract malformations or bladder disturbances. Treatment of an upper UTI needs to be broad and last for 10 days, a lower UTI only needs to be treated for 3 days, often with a narrow-spectrum antibiotic, and asymptomatic bacteriuria is best left untreated. Investigations of atypical and recurrent episodes of febrile UTI should focus on urinary tract abnormalities, whereas in cases of cystitis and asymptomatic bacteriuria the focus should be on bladder function.
🔗https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30676-0/fulltext
https://www.medscape.com/viewarticle/931111?src=soc_tw_200530_mscpedt_news_peds_antibiotics&faf=1
#uti #review #urology #pediatrics #lancet
📌Urinary tract infections (UTIs) in children are among the most common bacterial infections in childhood. They are equally common in boys and girls during the first year of life and become more common in girls after the first year of life. Dividing UTIs into three categories; febrile upper UTI (acute pyelonephritis), lower UTI (cystitis), and asymptomatic bacteriuria, is useful for numerous reasons, mainly because it helps to understand the pathophysiology of the infection. A single episode of febrile UTI is often caused by a virulent Escherichia coli strain, whereas recurrent infections and asymptomatic bacteriuria commonly result from urinary tract malformations or bladder disturbances. Treatment of an upper UTI needs to be broad and last for 10 days, a lower UTI only needs to be treated for 3 days, often with a narrow-spectrum antibiotic, and asymptomatic bacteriuria is best left untreated. Investigations of atypical and recurrent episodes of febrile UTI should focus on urinary tract abnormalities, whereas in cases of cystitis and asymptomatic bacteriuria the focus should be on bladder function.
🔗https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30676-0/fulltext
https://www.medscape.com/viewarticle/931111?src=soc_tw_200530_mscpedt_news_peds_antibiotics&faf=1
#uti #review #urology #pediatrics #lancet
Medscape
Latest Research on Treating Common Bacterial Infections in Kids: A Short Summary
A quick summary of the latest research on antibiotic choice in treatment of common infections in children.
👉Lyme borreliosis: diagnosis and management
📌Lyme borreliosis is the most common vectorborne disease in the northern hemisphere. It usually begins with erythema migrans; early disseminated infection particularly causes multiple erythema migrans or neurologic disease, and late manifestations predominantly include arthritis in North America, and acrodermatitis chronica atrophicans (ACA) in Europe. Diagnosis of Lyme borreliosis is based on characteristic clinical signs and symptoms, complemented by serological confirmation of infection once an antibody response has been mounted. Manifestations usually respond to appropriate antibiotic regimens, but the disease can be followed by sequelae, such as immune arthritis or residual damage to affected tissues. A subset of individuals reports persistent symptoms, including fatigue, pain, arthralgia, and neurocognitive symptoms, which in some people are severe enough to fulfil the criteria for post-treatment Lyme disease syndrome. The reported prevalence of such persistent symptoms following antimicrobial treatment varies considerably, and its pathophysiology is unclear. Persistent active infection in humans has not been identified as a cause of this syndrome, and randomized treatment trials have invariably failed to show any benefit of prolonged antibiotic treatment. For prevention of Lyme borreliosis, post-exposure prophylaxis may be indicated in specific cases, and novel vaccine strategies are under development.
🔗https://www.bmj.com/content/369/bmj.m1041
👉open access
#lyme #review #infections #bmj
📌Lyme borreliosis is the most common vectorborne disease in the northern hemisphere. It usually begins with erythema migrans; early disseminated infection particularly causes multiple erythema migrans or neurologic disease, and late manifestations predominantly include arthritis in North America, and acrodermatitis chronica atrophicans (ACA) in Europe. Diagnosis of Lyme borreliosis is based on characteristic clinical signs and symptoms, complemented by serological confirmation of infection once an antibody response has been mounted. Manifestations usually respond to appropriate antibiotic regimens, but the disease can be followed by sequelae, such as immune arthritis or residual damage to affected tissues. A subset of individuals reports persistent symptoms, including fatigue, pain, arthralgia, and neurocognitive symptoms, which in some people are severe enough to fulfil the criteria for post-treatment Lyme disease syndrome. The reported prevalence of such persistent symptoms following antimicrobial treatment varies considerably, and its pathophysiology is unclear. Persistent active infection in humans has not been identified as a cause of this syndrome, and randomized treatment trials have invariably failed to show any benefit of prolonged antibiotic treatment. For prevention of Lyme borreliosis, post-exposure prophylaxis may be indicated in specific cases, and novel vaccine strategies are under development.
🔗https://www.bmj.com/content/369/bmj.m1041
👉open access
#lyme #review #infections #bmj
👉Down syndrome
📌Down syndrome is phenotypically variable, but programs have been introduced to capitalize on each person’s best abilities. Guidelines for surveillance of the many associated medical problems and guidance for managing problems that are unique to Down syndrome are available.
🔗https://www.nejm.org/doi/full/10.1056/NEJMra1706537
#down #nejm #review
📌Down syndrome is phenotypically variable, but programs have been introduced to capitalize on each person’s best abilities. Guidelines for surveillance of the many associated medical problems and guidance for managing problems that are unique to Down syndrome are available.
🔗https://www.nejm.org/doi/full/10.1056/NEJMra1706537
#down #nejm #review
👉Pharmacokinetics during therapeutic hypothermia for neonatal hypoxic ischaemic encephalopathy: a literature review
📌Depending on the drug-specific disposition characteristics, therapeutic hypothermia in neonates with hypoxic ischaemic encephalopathy affects pharmacokinetics.
🔗http://dx.doi.org/10.1136/bmjpo-2020-000685
#hypothermia #pharmacology #hie #bmj #review
📌Depending on the drug-specific disposition characteristics, therapeutic hypothermia in neonates with hypoxic ischaemic encephalopathy affects pharmacokinetics.
🔗http://dx.doi.org/10.1136/bmjpo-2020-000685
#hypothermia #pharmacology #hie #bmj #review
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👉Imaging modalities and treatment of paediatric upper tract urolithiasis: A systematic #review and update on behalf of the EAU urolithiasis #guidelines panel
📌In the initial assessment of paediatric #urolithiasis, US is recommended as first #imaging modality, while non-contrast CT is the second option. SWL is recommended as first line treatment for renal stones <20 mm and for ureteral stones<10 mm. #Ureteroscopy is a feasible alternative both for ureteral stones not amenable to SWL as well as for renal stones <20 mm (using flexible). PNL is recommended for renal stones >20 mm.
🔗https://www.jpurol.com/article/S1477-5131(20)30413-7/fulltext
#nephrology #urology
👉Imaging modalities and treatment of paediatric upper tract urolithiasis: A systematic #review and update on behalf of the EAU urolithiasis #guidelines panel
📌In the initial assessment of paediatric #urolithiasis, US is recommended as first #imaging modality, while non-contrast CT is the second option. SWL is recommended as first line treatment for renal stones <20 mm and for ureteral stones<10 mm. #Ureteroscopy is a feasible alternative both for ureteral stones not amenable to SWL as well as for renal stones <20 mm (using flexible). PNL is recommended for renal stones >20 mm.
🔗https://www.jpurol.com/article/S1477-5131(20)30413-7/fulltext
#nephrology #urology