Conservative management can be safely achieved in ureteropelvic junction obstruction with poor drainage. Scheduled controls are needed for early discovery of functional renal deterioration. High-grade hydronephrosis is unlikely to resolve spontaneously and is often accompanied by a loss of renal function during the first years of life. What is Known: • There is controversy about which management should be adopted in infants with unilateral ureteropelvic junction obstruction with poor drainage but good differential renal function. What is New: • Long-term follow-up suggests that conservative management can be safely achieved also in unilateral ureteropelvic junction obstruction with poor drainage in more than 60% of cases, even if high-grade hydronephrosis is unlikely to resolve spontaneously and it is often accompanied by a loss of renal function during the first years of life. In our experience, surgical intervention was required in more than 50% of cases before 1 year of life and in all cases before 3 years of life.

Objective Congenital anomalies are important causes of morbidity and mortality in children. Oxidative stress (OS) is involved in the physiopathology of pregnancy-related congenital malformations. This review summarizes the role of OS in the pathogenesis of congenital malformations; in particular, its purpose is to describe how OS influences the development of heart congenital malformations, oesophageal atresia, biliary atresia, diaphragmatic hernia, and autosomal dominant polycystic kidney disease. Study Design Systematic review of previous studies about the role of OS in pregnancy and its possible effects in developing of congenital malformations. One electronic database (PubMed) was searched and reference lists were checked. Results An imbalance between the production of reactive oxygen species (ROS) and antioxidant defense can occur early in pregnancy and continue in the postnatal life, producing OS. It may destroy the signaling pathways needed for a correct embryogenesis leading to birth defects. In fact, cell functions, especially during embryogenesis, needs specific signaling pathways to regulate the development. These pathways are sensitive to both endogenous and exogenous factors; therefore, they can produce structural alterations of the developing fetus. Conclusion Because OS plays a significant role in pathogenesis of congenital malformations, studies should be developed in order to better define their OS mechanisms and the beneficial effects of supplemental therapeutic strategies. Key Points

Background data Ganglioneuroma is rare in children and often incidentally discovered. The transperitoneal laparoscopic approach is the surgical choice for most of the surgeons because of the familiar anatomy and the wider working spaces. However, a posterior retroperitoneal approach started to be used in pediatric population demonstrating to be safe and effective. Case presentation We present a case of a child with radiological finding of a right adrenal mass. Due to the increased risk of having a malignant transformation, a surgical resection was decided using a retroperitoneal approach. The adrenal mass was recognized and completely enucleated. The histopathological examination revealed a GN. Clinical course was uneventful with hospital discharge after 3 days. The outcome was evaluated by ultrasound examination performed 3–6 to 12–24 months and then annually. After 24 months, the patient is completely asymptomatic, and no adrenal masses in both sides have been detected. Conclusions The posterior retroperitoneoscopy permits a more direct exposure of the adrenal gland, without violating the peritoneum, and a close vision to the main vessels. We believe that this technique is a valid option for pediatric patients with small adrenal lesions.

Introduction: Recent data suggest that the removal rate of drugs is higher in predilution on-line hemodiafiltration(HDF) treatment because of the result in temporary reduction of serum protein binding rate. However, as far as searching, there are few studies comparing drug removal rates for Online-HDF and conventional hemodialysis therapy (HD). In this study, we compared the removal rate of drugs between in predilution on-line HDF and HD treatment. Methods: Twelve stable patients (two pairs) on regular thrice-weekly predilution online-HDF treatment were recruited. Six patients of them were taking amlodipine and the others were taking cinacalcet. They were assigned to two treatment periods of each four weeks for predilution online-HDF and conventional HD treatment. We measured the concentration in blood of the two drugs on the first therapy day of each 1st, third, fifth and seventh week. The replacement fluid amount in online-HDF was set to 48 L per session, and the membrane area of the haemodiafilter and dialyzer of the same patient was assumed to be the same. The removal rate of two drugs after hematocrit correction were compared between the two treatments. The concentrations of each drug were determined by high performance liquid chromatography after serum protein was eluted. Similarly, we measured small-sized molecules, that are urea nitrogen, creatinine and inorganic phosphorus, and low molecular weight