Background:We assess the potency of different Doppler indices in the differentiation of obstructive and nonobstructive hydronephrosis.Materials and Methods:In this study, infants and children who were referred for the evaluation of unilateral hydronephrosis were enrolled. Ultrasonography for the assessment of the degree of hydronephrosis and a voiding cystourethrogram for the exclusion of vesicoureteral reflux was performed. Then, Doppler ultrasonography was done for both kidneys of each patient using four classic Doppler indices as well as the difference (delta) of each index between to kidneys. Diuretic renography with 99 mTc-ethylene dicysteine (99 mTc-EC) was performed for each patient.Results:Thirty-nine patients met the inclusion criteria. After diuretic renography, 29 (74.35%) patients had shown a nonobstructive pattern, and ten (25.65%) patients had a partial (intermediate) or complete obstruction. Using receiver operating characteristic (ROC) curve, none of the classic indices of Doppler duplex (i.e., resistive index [RI], resistance index, end diastolic velocity, and peak systolic velocity) had the ability to make a difference between obstructive and nonobstructive hydronephrosis. However, by calculating the difference (delta) of these indices between two kidneys of each patient, delta RI could differentiate the nonobstructive condition, significantly (P = 0.006). A cutoff value of 0.055 has 60% sensitivity and 82.8% specificity. The area under the ROC curve for delta RI is 0.795 (standard error: 0.086, 95% confidence interval [CI]: 0.626, 0.964). Furthermore, RI ratio between two kidneys of each patient could differentiate the nonobstructive condition, significantly (P = 0.012). A cutoff point of 1.075 has 70% sensitivity and 82.8% specificity. The area under the ROC curve for RI ratio was 0.769 (standard error: 0.104, 95% CI: 0.565, 0.973).Conclusion:This study shows that RI ratio and delta RI with a high specificity could differentiate nonobstructive hydronephrosis and therefore it is a promising way to use especially in the follow-up of children with hydronephrosis.
Background: Urinary tract infection and pyelonephritis are clinical problems that frequently occur in children. Several factors are responsible for renal tissue injury, morbidity, and renal scarring after pyelonephritis. The aim of this study was to evaluate the preventive effect of l-carnitine on renal scarring in acute pyelonephritis. Methods: A randomized double-blind clinical trial was conducted on 65 children aged 6 months to 10 years. Patients were randomized into 2 groups to receive 7-day treatment with only antibiotics without l-carnitine (control group; n = 32) and 7-day treatment with l-carnitine (case group; n = 33) during the acute phase of infection. Technetium-99m-labeled dimercaptosuccinic acid (DMSA) scintigraphy was performed for all children during the acute phase (in 2–7 days of hospitalization) and late phase. P-value less than 0.05 was statistically significant. Results: We recruited 65 participants in the study: 32 children in control group and 33 children in case group. Three children in the control group and 2 children in the case group refused to perform the second DMSA scan. Overall, data analysis at the end of the study was done on 60 patients. Age distribution of girl patients with upper urinary infection was 6.5% in girl children aged between 6 months and 12 months, 41.1% aged between 1 and 5 years, 33.3% aged between 5 and 10 years, respectively. There was no significant difference between 2 groups in age and sex. There was no significant difference between 2 groups in systolic blood pressure, diastolic blood pressure, the lab data including urine white blood cells and serum erythrocyte sedimentation rate, and antibiogram profiles. Voiding dysfunction was detected in 10% of the participants. The baseline DMSA was not significantly difference in 2 groups, but worsening of kidney lesions was significantly higher in control group after 6 months (P = 0.012). Conclusion: Our study showed that l-carnitine significantly decreased renal scarring because of acute pyelonephritis.
Abstract. Sediment-water oxygen fluxes are widely used as a proxy for organic carbon production and mineralization at the seafloor. In-situ fluxes can be measured non-invasively with the aquatic eddy covariance technique, but a main weakness of the commonly used instrumentation is the susceptibility of the delicate oxygen microsensors required for the high frequency measurements to disturbances. Even small changes in sensor characteristics during deployment as caused e.g. by biofouling can result in erroneous flux data. Here we present a dual-optode eddy covariance instrument (2OEC) with two fast oxygen fiber sensors and document how erroneous flux interpretations and data loss can effectively be reduced by this hardware and a new data analysis approach. With deployments over a carbonate sandy sediment in the Florida Keys and comparison with parallel benthic advection-chamber incubations, we demonstrate the improved data quality and data reliability facilitated by the instrument and associated data processing. Short-term changes in flux that are questionable in single oxygen sensor instruments can be confirmed or rejected with the 2OEC and in our deployments provided new insights into the temporal dynamics of benthic oxygen flux in permeable carbonate sands. With the 2OEC, reliable benthic flux data can be generated within a couple of hours, making this technique suitable for mapping sediment-water, intra-water column, or atmosphere-water fluxes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.