A prospective study of serum concentrations of leptin, homocysteine and insulin resistance in children with steroid-sensitive nephrotic syndrome

Aim: To measure serum leptin, homocysteine concentrations and insulin resistance in active and remission stages of children with nephrotic syndrome (NS) and to investigate their role in NS pathogenesis. Methods: A total of 70 children were included in the study, 40 patients who had been diagnosed with NS and 30 healthy patients were control. Changes in plasma concentration of the serum homocysteine, leptin, and insulin were measured and compared with the other parameters in the groups. Results: Serum leptin concentrations in active phase were lower than the remission phase (1.48 ± 0.09 ng/dl, 1.84 ± 1.64 ng/ml, p<0.05). Also, serum homocysteine concentrations in NS group during the active phase were lower than the remission phase and the control group (6.45±2.54 ng/dl, 9.35±2.99 ng/ml, 7.76± 1.97 ng/ml, p<0.05). The serum fasting insulin concentrations and homeostatic model assessment for insulin resistance (HOMA-IR) values of remission phase were significantly higher than those of active phase (p<0.05). A positive relationship was found between the homocysteine concentrations and the body mass index of the patient; whereas, a negative relationship was detected between erythrocyte sedimentation rate (ESR), and the LDL-cholesterol concentrations (p<0.05). ESR was found as the only factor associated with lower concentrations of homocysteine during the active phase (r:-0.592, p<0.05).  Conclusion: In this study, we demonstrated that serum leptin and homocysteine concentrations decreased in active phase and increased in remission phase in children with NS.  Insulin resistance could also develop as a result of steroid use in a short period of time in these patients

Hypercalciuria in children with monosymptomatic nocturnal enuresis

Objective: The aim of this study was to measure the 24 h urinary calcium content in children with monosymptomatic nocturnal enuresis (MNE) and compare with those in healthy children to investigate whether there is any relation with enuresis and hypercalciuria

The quality of life of mothers of children with monosymptomatic enuresis nocturna

The purpose of this study was to assess the effect of monosymptomatic nocturnal enuresis (MNE) on the quality of life of the mothers

Control of bleeding associated with hemophagocytic syndrome in children: An audit of the clinical use of recombinant activated factor VII

This paper presents 2 cases of hemophagocytic lymphohistiocytosis (HLH) in whom recombinant factor VIIa ( rFVIIa) was used for the management of hemorrhage. Both patients were diagnosed as HLH and were bleeding from the gut, which could not be controlled. Patients received rFVIIa at total doses of between 90 and 180 mu g/kg body weight. Hemostatic affect was achieved in both of the patients but lasted only a short time. The response was achieved after 1 h of administration of rFVIIa, lasting for 24 h. The use of rFVIIa was well tolerated. These 2 patients suggest that rFVIIa is a beneficial agent in the management of hemorrhage in patients with HLH, although for a permanent homeostasis the control of primary disease is essential

Blood volume monitoring to adjust dry weight in hypertensive pediatric hemodialysis patients

The aim of this study was to adjust dry weight by short-term blood volume monitoring (BVM)-guided ultrafiltration and evaluate the effects of optimizing dry weight on blood pressure (BP) control and intradialytic symptoms (IDS) in a group of hypertensive hemodialysis (HD) patients. The study was performed in four sequential phases, each of which lasted for 1 week, on nine hypertensive HD patients (six girls, age 16.9 +/- 3.1 years). In phase I, patients were observed by BVM. In phase II, BVM was used to guide ultrafiltration to adjust dry weight. Antihypertensive drugs were gradually tapered or withheld in phase III, when the patients were hypotensive and/or their IDS increased. In phase IV, this particular weight was maintained without any intervention. Pre- and post-HD body weight, pre-HD, post-HD, 30 min after HD casual BP values, and IDS in each HD session were recorded. The BP was also assessed by 44-h ambulatory BP monitoring (ABPM), which is an ideal method to determine BP changes throughout the interdialytic period at the beginning of phase I and at the end of phase IV. There was a decrease in mean dry weight, all casual systolic BPs, and systolic/diastolic ABPM at the end of the study (all p a parts per thousand currency signaEuro parts per thousand 0.05). Antihypertensive drugs were stopped in five patients and reduced in two during phase III of the study. The IDS was more frequent (36%) in phase IV than in phase I (16%); however, this increase did not reach statistical significance. The results of this study suggest that short-term BVM guided-ultrafiltration may be a useful tool to diagnose volume overload and to adjust dry weight and, consequently, to achieve a better control of BP in pediatric HD patients

The Role of Serum Vitamin D Level on Lower Respiratory Tract Infections in Children

Objective: The aim of this study was to evaluate the effect of serum 25 (OH) vitamin D levels on the clinical aspect of acute lower respiratory tract infections (LRTIs) in children

The Role of Serum Vitamin D Level on Lower Respiratory Tract Infections in Children

Objective: The aim of this study was to evaluate the effect of serum 25 (OH) vitamin D levels on the clinical aspect of acute lower respiratory tract infections (LRTIs) in children