The Experts below are selected from a list of 228 Experts worldwide ranked by ideXlab platform
Russell W Chesney - One of the best experts on this subject based on the ideXlab platform.
-
is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing Pyelonephritis and renal scars a randomized controlled trial
Pediatrics, 2008Co-Authors: Ron Keren, Myra A Carpenter, Saul P Greenfield, Alejandro Hoberman, Ranjiv Mathews, Tej K Mattoo, Russell W ChesneyAbstract:OBJECTIVES. There has been intense discussion on the effectiveness of continuous antibiotic prophylaxis for children with vesicoureteral reflux, and randomized, controlled trials are still needed to determine the effectiveness of long-term antibiotics for the prevention of acute Pyelonephritis. In this multicenter, open-label, randomized, controlled trial, we tested the effectiveness of antibiotic prophylaxis in preventing recurrence of Pyelonephritis and avoiding new scars in a sample of children who were younger than 30 months and vesicoureteral reflux. METHODS. One hundred patients with vesicoureteral reflux (grade II, III, or IV) diagnosed with cystourethrography after a first episode of acute Pyelonephritis were randomly assigned to receive antibiotic prophylaxis with sulfamethoxazole/trimethoprim or not for 2 years. The main outcome of the study was the recurrence of Pyelonephritis during a follow-up period of 4 years. During follow-up, the patients were evaluated through repeated cystourethrographies, renal ultrasounds, and dimercaptosuccinic acid scans. RESULTS. The baseline characteristics in the 2 study groups were similar. There were no differences in the risk for having at least 1 Pyelonephritis episode between the intervention and control groups. At the end of follow-up, the presence of renal scars was the same in children with and without antibiotic prophylaxis. CONCLUSIONS. Continuous antibiotic prophylaxis was ineffective in reducing the rate of Pyelonephritis recurrence and the incidence of renal damage in children who were younger than 30 months and had vesicoureteral reflux grades II through IV.
Massoud Majd - One of the best experts on this subject based on the ideXlab platform.
-
dimercaptosuccinic acid renal scintigraphy for the evaluation of Pyelonephritis and scarring a review of experimental and clinical studies
The Journal of Urology, 1992Co-Authors: Gil H Rushton, Massoud MajdAbstract:AbstractRenal cortical scintigraphy has been reported to be useful in children for confirmation of the diagnosis of acute Pyelonephritis. Subsequent experimental studies have demonstrated that dimercaptosuccinic acid (DMSA) scintigraphy, when compared directly with histopathology, is highly reliable for the detection and localization of parenchymal inflammatory changes associated with acute Pyelonephritis. Recent clinical studies of acute Pyelonephritis using DMSA scintigraphy reveal that the majority (50 to 91%) of children with febrile urinary tract infections have abnormal DMSA renal scan findings and that the majority of these children do not have demonstrable vesicoureteral reflux. However, when vesicoureteral reflux is present, renal cortical abnormalities are demonstrated by DMSA scintigraphy in 79 to 86% of the kidneys. In children with febrile urinary tract infections routine clinical and laboratory parameters are not reliable in the differentiation of acute Pyelonephritis, documented by DMSA ren...
H G Rushton - One of the best experts on this subject based on the ideXlab platform.
-
the evaluation of acute Pyelonephritis and renal scarring with technetium 99m dimercaptosuccinic acid renal scintigraphy evolving concepts and future directions
Pediatric Nephrology, 1997Co-Authors: H G RushtonAbstract:Technetium 99m-dimercaptosuccinic acid (DMSA) scintigraphy has emerged as the imaging agent of choice for the detection and evaluation of acute Pyelonephritis and renal cortical scarring in children. Consequently, DMSA scintigraphy provides a unique opportunity to study the progression of renal damage and functional loss from the initial insult of acute Pyelonephritis to the subsequent development of irreversible renal scarring. Over the last few years, clinical and experimental investigations using DMSA renal scintigraphy have provided new insights into the etiology, pathophysiology, and clinical outcome of acute Pyelonephritis in children. These studies have confirmed the primary role of the acute inflammatory response, associated with both reflux and nonreflux Pyelonephritis, in the etiology of irreversible renal scarring. Furthermore, several studies have shown that renal scarring can be prevented or diminished by the early diagnosis and treatment of Pyelonephritis. This review highlights these recent observations and makes recommendations regarding current clinical and future research applications.
George D Wendel - One of the best experts on this subject based on the ideXlab platform.
-
acute Pyelonephritis in pregnancy
Obstetrics & Gynecology, 2005Co-Authors: James B Hill, Jeanne S Sheffield, Donald D Mcintire, George D WendelAbstract:OBJECTIVE:To examine the incidence of Pyelonephritis and the incidence of risk factors, microbial pathogens, and obstetric complications in women with acute antepartum Pyelonephritis.METHODS:For 2 years, information on pregnant women with acute Pyelonephritis was collected in a longitudinal study. A
Young Seo Park - One of the best experts on this subject based on the ideXlab platform.
-
risk factors for renal scar formation in infants with first episode of acute Pyelonephritis a prospective clinical study
The Journal of Urology, 2012Co-Authors: Young Seo ParkAbstract:Purpose: We prospectively determined the risk factors for renal scar formation after the first episode of acute Pyelonephritis as confirmed on dimercapto-succinic acid scintigraphy in children younger than 1 year.Materials and Methods: A total of 213 infants with acute Pyelonephritis were enrolled in the study. Infants with urological abnormalities other than vesicoureteral reflux were excluded from analysis. Followup scanning was performed 6 months after acute Pyelonephritis and voiding cystourethrography was performed after the acute phase of infection. Possible risk factors were evaluated including gender, peak fever, duration of fever before and after treatment with antibiotics, white blood cell count, C-reactive protein concentration, presence of vesicoureteral reflux and reflux grade.Results: Six months after acute Pyelonephritis 37 of 213 (17.4%) infants and 41 of 248 (16.5%) renal units with acute photon defects on initial dimercapto-succinic acid scintigraphy had renal scars. The rates of scar fo...
