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BackgroundPeritoneal dialysis (PD) is the most common kidney replacement therapy in children. Complications associated with PD affect treatment success and sustainability. The aim of this study was to investigate the frequency of PD-related non-infectious complications and the predisposing factors.MethodsRetrospective data from 11 centers in Turkey between 1998 and 2018 was collected. Non-infectious complications of peritoneal dialysis (NICPD), except metabolic ones, in pediatric patients with regular follow-up of at least 3 months were evaluated.ResultsA total of 275 patients were included. The median age at onset of PD and median duration of PD were 9.1 (IQR, 2.5–13.2) and 7.6 (IQR, 2.8–11.9) years, respectively. A total of 159 (57.8%) patients encountered 302 NICPD within the observation period of 862 patient-years. The most common NIPCD was catheter dysfunction (n = 71, 23.5%). At least one catheter revision was performed in 77 patients (28.0%). Longer PD duration and presence of swan neck tunnel were associated with the development of NICPD (OR 1.191; 95% CI 1.079–1.315, p = 0.001 and OR 1.580; 95% CI 0.660–0.883, p = 0.048, respectively). Peritoneal dialysis was discontinued in 145 patients; 46 of whom (16.7%) switched to hemodialysis. The frequency of patients who were transferred to hemodialysis due to NICPD was 15.2%.ConclusionsPeritoneal dialysis-related non-infectious complications may lead to discontinuation of therapy. Presence of swan neck tunnel and long duration of PD increased the rate of NICPD. Careful monitoring of patients is necessary to ensure that PD treatment can be maintained safely.

Purpose To investigate the relationship between cell content and histopathological features of parathyroid lesions and 18F-FCH uptake intensity on PET/CT images. Methods Patients with primary hyperparathyroidism (age > 18) who were referred to 18F-FCH PET/CT were involved. All patients underwent parathyroidectomy. Correlation of SUVmax with following factors were statistically analysed: serum PTH, Ca, P levels and histopathological parameters, total absolute amounts of chief cell, oxyphyllic cell and clear cell components calculated by the multiplication of the volume of the parathyroid lesion and the percentage of each type of cell content (called as Absolute chief , Absolute oxyphyllic and Absolute clear reflecting the total amount of each cell group). Results A total of 34 samples from 34 patients (6M, 28F, mean age: 53.32 ± 15.15, min: 14, max: 84) who had a positive 18F-FCH PET/CT localizing at least one parathyroid lesion were involved. In the whole study group, SUVmax was found to be correlated with the greatest diameter and volume of the lesion and Absolute chief ( p  = 0.004, p  = 0.002 and p  = 0.035, respectively). In the subgroup analysis of 28 samples with longest diameter > 1 cm, the correlation between SUVmax and Absolute chief remained significant ( p  = 0.036) and correlation between SUVmax and volume and longest diameter became stronger ( p  = 0.011 and p  > 0.001, respectively). No correlation was found between SUVmax and Absolute oxyphyllic or Absolute clear . Conclusions There might be a relationship between 18F-FCH uptake intensity and chief cell content in patients with parathyroid adenoma. Further studies with larger patient groups would be beneficial to support the data.

Two trials were conducted to study the effects of heat stress during rearing (trial 1) and crating (trial 2) on broiler stress parameters and fear, breast meat quality, and nutrient composition. The relationships between stress parameters and meat quality traits were also determined. Trial 1 consisted of 3 temperature treatments from 3 to 7 wk: control (temperature was 22°C); diurnal cyclic temperature (temperature was 28°C from 1000 to 1700 h and 22°C from 1700 to 1000 h); and constant high temperature (34°C; temperature was 34°C). In trial 2, broilers from the control and 34°C groups in trial 1 were used. Broilers in each group were placed in transport cages. The 9 cages from the control group were divided into 3 groups and placed into 3 rooms at 15, 22, or 34°C for 2 h. The 3 cages from the 34°C group were also held in the room at 34°C (34-34°C). Diurnal cyclic temperature had no effect on BW up to 5 wk of age. The effect of 34°C constant temperature on BW of broilers increased with age. Plasma levels of glucose and albumin increased by 34°C, but no dramatic change in levels occurred when those broilers were crated at 34°C. The heterophil:lymphocyte (H:L) was higher for the 34-34°C broilers and the control broilers in the 34°C room than those from the 22 and 15°C room. Breast muscle glycogen level decreased in broilers reared under diurnal cyclic or high temperatures. A lower pH and higher lightness (L*) and redness values and redness:yellowness were found in meat for broilers from both 34°C and 34-34°C groups. Higher H:L was associated with breast muscle pH according to first-order polynomial regression. The H:L had a significant effect on L* values, which were described by a second-order polynomial regression. Blood glucose level was positively correlated with L* and redness values. Duration of tonic immobility was neither influenced by rearing and crating temperatures nor associated with meat quality parameters.

Predicting vesico-ureteral reflux (VUR) ≥3 at the time of the first urinary tract infection (UTI) would make it possible to restrict cystography to high-risk children. We previously derived the following clinical decision rule for that purpose: cystography should be performed in cases with ureteral dilation and a serum procalcitonin level ≥0.17 ng/mL, or without ureteral dilatation when the serum procalcitonin level ≥0.63 ng/mL. The rule yielded a 86% sensitivity with a 46% specificity. We aimed to test its reproducibility. A secondary analysis of prospective series of children with a first UTI. The rule was applied, and predictive ability was calculated. The study included 413 patients (157 boys, VUR ≥3 in 11%) from eight centers in five countries. The rule offered a 46% specificity (95% CI, 41-52), not different from the one in the derivation study. However, the sensitivity significantly decreased to 64% (95%CI, 50-76), leading to a difference of 20% (95%CI, 17-36). In all, 16 (34%) patients among the 47 with VUR ≥3 were misdiagnosed by the rule. This lack of reproducibility might result primarily from a difference between derivation and validation populations regarding inflammatory parameters (CRP, PCT); the validation set samples may have been collected earlier than for the derivation one. The rule built to predict VUR ≥3 had a stable specificity (ie. 46%), but a decreased sensitivity (ie. 64%) because of the time variability of PCT measurement. Some refinement may be warranted.

Aim In this study, it was aimed to explore the prognostic factors in patients who received selective internal radiation therapy for hepatocellular cancer. Materials and methods A retrospective evaluation was made of 28 (24 male, 4 female, mean age 65.4 ± 6.8 years) hepatocellular cancer patients who received selective internal radiation therapy with Y-90 resin microspheres. Using Cox proportional hazards regression analysis, the relationship between age, gender, MELD score, serum albumin and AFP levels, number of liver lesions, size of the largest lesion, absence of 18 F-FDG uptake, maximum standardized uptake value and overall survival times was analyzed. Results Treatment was applied to the right lobe in 22 and both in 6 patients. Mean treatment dose was 1.5 ± 0.2 GBq. Number of liver lesions were 1, <5 and multiple in 16, 5 and 7 patients, respectively, and the mean size of the largest lesion was 41.5 mm (min–max 15–160 mm). While 18 F-FDG uptake was seen in 24 patients, liver lesions were hypometabolic in 4 patients. Mean SUV max of liver lesions was calculated as 5.3 ± 0.3. During the mean 17.8 (min–max 2–39) months follow-up period, 19 patients died. Median survival time was computed as 18 ± 5 months (95 % CI 8.1–27.8). Age ( p  = 0.04), serum AFP level ( p  = 0.03) and size of the largest lesion ( p  = 0.02) had a significant negative effect on survival according to the Cox proportional hazards regression analysis. Conclusion Age, serum AFP level and the size of the largest liver lesion have a negative significant effect on survival of hepatocellular cancer patients who received selective internal radiation therapy.

Objective The objective was to investigate the clinical features and metabolic and anatomic risk factors for kidney stone formation in our patient group. Methods Between 1998 and 2005, 179 children (94 girls, 85 boys) followed in our department because of urolithiasis were enrolled to participate in our study. Clinical presentation, urinary tract infection, stone localisation, positive family history, stone composition, presence of anatomic abnormalities and urinary metabolic risk factors, and treatment modality were evaluated retrospectively. Results The mean age at diagnosis of stone disease was 4.5 years (range 0.25–15.3 years). The mean follow-up duration was 8 months (range 1–98). The major clinical presentations of our patients were abdominal pain and/or flank pain in 100 children (55.9%) and macroscopic hematuria in 25 (14%). Urinary tract infection was detected in 20% of patients on admission. Forty-three children (24%) had a urinary tract abnormality and ureteropelvic junction obstruction was the most common abnormality. A family history of stone disease was recorded in 98 patients (54.7%). Stones were located within the renal parenchyma in 90 patients. Hypercalciuria and hyperuricosuria were detected in 42.3 and 54.8% respectively. Stone analysis was performed in 63 children and calcium oxalate was a major mineral. Surgical treatment was performed in 49 children and extracorporeal shock wave lithotripsy (ESWL) in 41 children. Conclusion We think that urolithiasis remains a serious problem in children in our country. Family history of urolithiasis, urologic abnormalities (especially under the age of 5 years), metabolic disorders and urinary tract infections tend to indicate childhood urolithiasis.

Discussion Cardiac hydatid cysts are extremely rare particularly in the pediatric age. Because of its potential risk for rupture resulting in systemic or pulmonary dissemination, embolism or anaphylactic shock, prompt diagnosis and early surgery is crucial.

There was a spelling error in the fifteenth author's name. (2012) Correction: Prediction of High-Grade Vesicoureteral Reflux after Pediatric Urinary Tract Infection: External Validation Study of Procalcitonin-Based Decision Rule.

Adult onset Still's Disease (ASD) is a systemic inflammatory disorder of unknown etiology characterized by chronic and fluctuant fever with accompanying rash, polyarthritis and involvement of multiple organs, especially lymphoid tissues. Although kidney involvement may appear in some cases of adult Still's disease, membranous glomerulonephyritis has not been described before. We herein report a 38-year-old man diagnosed with Still's disease with longstanding polyarthritis unresponsive to high-dose steroids and various immunosuppressive drugs for 5 years. He was referred to our clinic with bilateral pretibial edema on his legs. Urine examination revealed 10.5 g/day proteinuria with membranous glomerulonephritis and his renal biopsy came up with it. Infliximab was initiated, and his complaints were totally resolved also with a normal urine test in the following 3 months. To the best of our knowledge, this is the first report that clearly shows the efficacy of infliximab in a patient with refractory ASD with membranous glomerulonephyritis.