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Biomedical subjects

J Toporovski

Publications and source records attributed to J Toporovski.

13 recordsLinked to original sources
PubMed1992

Urolithiasis in childhood: metabolic evaluation.

In order to determine metabolic disorders in children with urolithiasis, 50 patients with urinary calculi were studied. Abdominal pain and/or haematuria were the most predominant symptoms. Surgical procedures were required in 22% of these children and urinary tract infection was observed in 34% of this group. Only 2 children had anatomical malformations of the urinary tract. Absorptive hypercalciuria (32%), renal hypercalciuria (34%) and uric acid hyperexcretion (24%) were the most common metabolic abnormalities in these children. We were unable to find an underlying metabolic abnormality in only 14% of the patients. These data suggest that appropriate metabolic study will allow rational management of children with urinary stones.

Adolescent↗
PubMed1992

Effectiveness of cefetamet pivoxil in the treatment of pyelonephritis in children.

Cefetamet pivoxil was investigated in an open, randomized comparative study involving a total of 37 children with acute pyelonephritis, whose ages ranged from 2 to 14 years. The patients received either 10 mg/kg (n = 18) or 20 mg/kg (n = 8) cefetamet pivoxil twice daily, or 30-50 mg/kg amoxycillin/clavulanic acid three times daily (n = 11) for a period of 7-10 days. Escherichia coli was the main causative agent isolated in 28 (75.7%) of the patients; other pathogens included Proteus mirabilis (three patients). Proteus species (one patient), Klebsiella pneumoniae (two patients), Pseudomonas diminuta (one patient) and mixed infections (three patients). No differences in the overall treatment outcome could be observed between the treatment regimens used and, at the end of treatment, all pathogens were eradicated with neither relapse, nor persistence of the isolated pathogen, nor reinfection occurring. The clinical signs and symptoms had subsided in all patients at treatment end and the tolerability of the trial drugs was found to be satisfactory with no premature treatment withdrawal required. It is concluded that cefetamet pivoxil in the standard twice-daily dose of 10 mg/kg was equally effective and as well tolerated as 20 mg/kg cefetamet pivoxil given twice daily or 30-50 mg/kg amoxycillin/clavulanic acid given three times daily.

Acute Disease↗
PubMed1991

Metabolic disturbance as a cause of recurrent hematuria in children.

Metabolic disturbance as a cause of recurrent hematuria in children. To evaluate metabolic disturbance as a cause of hematuria, 250 children, aged eight months to fourteen years, with recurrent hematuria were studied. In the present series, metabolic disturbance was mainly due to idiopathic hypercalciuria (IH), the most common etiology of hematuria without proteinuria in childhood. Sixty-seven (27%) of the children had IH, ten children (4%) had hyperuricosuria, and 27 (11%) had nephrolithiasis. To better characterize the IH into renal (RH) or absorptive hypercalciuria (AH) subtypes, 45 of the 67 children (ranging age from six to twelve years) were further submitted to an oral calcium load test. Eighteen patients (40%) had AH, 7 (15.5%) RH and 20 (44.4%) could not be classified as having AH or RH [indeterminant (ID) idiopathic hypercalciuria group]. Intravenous pyelography or ultrasound were normal in all children. The oral calcium load test may be useful in characterizing the subtype of IH in some children; however, a great number of the IH children were characterized as indeterminant. Also hyperuricosuria, recently described as another metabolic disturbance associated with hematuria, may be an important cause of recurrent hematuria in children.

Adolescent↗
PubMedDate not supplied

[Recurrent hematuria in children: study of 250 cases].

In order to analyse the etiology of recurrent hematuria in childhood, we studied 250 children, referred to our Service (age: 6 mo-17 ys; 102 female and 148 male). They were submitted to the following protocol: urine analyses, uroculture, serum total and fraction complement, electrophoresis of hemoglobin, serum creatinine, BUN, 24h urinary calcium, uric acid and protein, oral calcium load test in children with hypercalciuria (UCa greater than 4mg/kg/day). Radiological evaluation and renal percutaneous biopsy was performed when necessary. The following diagnostic distribution was obtained: Alport syndrome, 19; Berger disease, 15; other glomerulopathies, 45; hypercalciuria, 67; uric acid hyperexcretion, 10; nephrolithiasis, 27; urinary tract infection, 14; renal malformation, 8; no diagnosis, 43. Based in these results, we conclude that appropriate investigation on recurrent hematuria, leads to determination of etiology in over 80% of cases.

Adolescent↗