In this section authors from Egypt describe the use of urinary TGFβ1 and epidermal growth factor in PUJ obstruction. In another paper, authors from London herald what they consider to be a new era in the management of end‐stage renal disease in children, presenting the technique of bilateral synchronous posterior prone retroperitoneoscopic nephrectomy with simultaneous peritoneal dialysis. OBJECTIVES To investigate the role of transforming growth factor β1 (TGF‐β1) and epidermal growth factor (EGF) in voided urine for the diagnosis and follow‐up of children with pelvi‐ureteric junction obstruction (PUJO). PATIENTS, SUBJECTS AND METHODS The study included 35 children with unilateral PUJO who had a pyeloplasty, and 30 healthy control children. Urine samples were obtained from the bladders of patients before surgery, and as voided samples at 1, 2, 3, 6, 9 and 12 months after surgery. Bladder urine samples were also collected from all 30 children in the control group. TGF‐β1 and EGF were then measured in all the urine samples. RESULTS The level of bladder TGF‐β1 before surgery in the patients was significantly higher than that in the healthy control group. A threshold of 190 pg/mg creatinine gave a sensitivity of 100%, a specificity of 80%, a positive predictive value of 85.4%, negative predictive value of 100% and an overall accuracy of 90.8%. Compared with the value before surgery, urinary TGF‐β1 was significantly lower at 1 year after pyeloplasty. There was no significant difference between the level of EGF before surgery in the patients and that in the control group, and no significant difference in the level of EGF before and after surgery over the follow‐up. CONCLUSION We do not recommend using EGF levels in voided urine in the routine diagnosis of children with hydronephrosis. The urinary level of TGF‐β1 is a useful noninvasive tool for the long‐term follow‐up of children with PUJO treated by pyeloplasty. Further studies with various controls are required to confirm the diagnostic accuracy of TGF‐β1 in children with PUJO.

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Voided urinary N-acetyl-beta-D-glucosaminidase, alkaline phosphatase and gamma-glutamyl transferase are accurate markers for differentiating between children with ureteropelvic junction obstruction requiring pyeloplasty and those with dilated nonobstructed kidneys suitable for conservative treatment. Measurement of these enzymes in voided urine could be used as a noninvasive tool for long-term followup of children with ureteropelvic junction obstruction after pyeloplasty and those receiving conservative treatment.

Background Gestational diabetes mellitus is the most common metabolic dysfunction that arises during pregnancy. GDM can lead to serious health complications for both the mother during pregnancy and after the delivery of the baby. Additionally, mother–offspring suffers from abnormalities in metabolism. The study aimed to investigate glutathione S‑transferase P1 and ghrelin genetic variants in pregnant women diagnosed with gestational diabetes using a tetra-primer amplification refractory mutation system. Results This study demonstrated that the frequencies of genotypes in women with GDM were GSTP1-AG (87.1%) and GHRL-GG (100%). The study revealed no significant differences in the frequency of either genotype or allele of both GSTP1 and ghrelin between GDM and healthy pregnant women. Conclusions This study may be the first study designed to demonstrate that there is no association between the genotype and allele frequencies of GSTP1 (rs1695) and ghrelin (rs696217) in the development of gestational diabetes mellitus in Egyptian women.

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