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常规排泄式膀胱尿道造影术对新生儿单侧多囊性肾发育不良无诊断意义

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世界核心医学期刊文摘（儿科学分册） 2006年第2期2卷 21-22页

作者： Ismaili K. Avni F.E. Alexander M. 郭战宏 hpital universitaire des enfants -reine fabiola Department of Perinatal and Pediatric Nephrology 15 Avenue J.J. CROCQ 1020 -Brussels Belgium Dr.

Objectives: To determine if two successive ultrasound examinations could rule out the presence of clinically significant contralateral anomalies in neonates with multicystic dysplastic kidney (MCDK), thereby avoiding unnecessary voiding cystourethrography (VCUG). Study design: We followed 76 newborn infants with antenatally discovered MCDK. Two successive neonatal renal ultrasound examinations were performed, one within the first week and one at around 1 month of life. VCUG and isotopic studies were performed in all infants. Results: Urologic anomalies of the contralateral kidney were present in 19 of 76 children (25% ): vesicoureteral reflux (VUR) in 16 (21% ), ureteropelvic junction obstruction in 2 (3% ), and renal duplex kidney in 1 (1% ). Sixty-one infants (80% of total) had normal contralateral urinary tract on the 2 successive neonatal renal ultrasound scans. Among them, 4 of 61 (7% ) infants presented with low-grade VUR on VCUG that had resolved spontaneously before 2 years of age. The sensitivity, specificity, positive predictive value, and negative predictive value of two successive ultrasound scans in the neonatal period to predict contralateral urological anomalies on VCUG were 75% , 95% , 80% , and 93% , respectively. Conclusions: In infants with antenatally diagnosed MCDK, two successive normal neonatal renal ultrasound scans will rule out clinically significant contralateral anomalies, thereby rendering the need for a neonatal VCUG unnecessary.

关键词：多囊性肾发育不良膀胱尿道造影术新生儿期诊断意义排泄膀胱输尿管逆流肾盂连接处梗阻阴性预测值出生前诊断单侧

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单侧复杂性双肾畸形儿童单个肾的功能改变

世界核心医学期刊文摘（儿科学分册） 2006年第1期2卷 29-30页

作者： Ismaili K. hall M. ham h. Piepsz A. 王一飞 hpital universitaire des enfants-reine fabiola Department of Perinatal and Pediatric Nephrology 15 Avenue J. J. Crocq 1020 Brussels Belgium Dr.

Objective: To assess the evolution of individual renal function during the mat uration process in terms of single kidney glomerular filtration rate (SKGFR) and split function in children with unilateral complex renal duplication. Study des ign: We retrospectively reviewed the records of 44 children with unilateral comp lex duplex kidney. All affected kidneys had a poor or nonfunctioning dysplastic moiety, 28 in the upper pole and 16 in the lower pole. At least 2 radioisotopic examinations, including a 99mTc-mercaptoacetyltriglycine (99mTc-MAG3) renogram and a plasma clearance of 51Cr-ethylenediaminetetraacetic acid (Cr-51 EDTA), were performed in all children, the first one performed at a median age of 3 mon ths (range 2 to 15 months) and the last one at 24 months (range 12 to 120 months ). They allowed a precise estimation of split renal function, overall glomerular filtration rate (GFR), and SKGFR. Results: Mean overall kidney GFR increased si gnificantly between the two measurements from 63 ±12.7 mL/minute/1.73m2 to 95 ±21 mL/minute/1.73m 2 (P he duplex side similarly increased from 26 ±7.7 mL/minute/1.73m2 to 38 ±12.6 mL/minute/1.73m2 (P he affected kidney had a remarkable stable function betw een the two measurements, 40%±8.6 and 39%±8.3 (P = .94), respectively. howev er, cases with the lowest initial split function ( had the lowest initia l SKGFR and the worst further evolution. Conclusion: In children with unilateral complex renal duplication, we found on the affected side a significant increase of SKGFR because of renal maturation, whereas mean split function remained stab le during follow-up.

关键词：肾畸形肾小球滤过率全或无肾上极评估单乙二胺四乙酸肾下极研究设计精确估算

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儿童男性化与父亲睾丸酮凝胶的应用

世界核心医学期刊文摘（儿科学分册） 2006年第A3期2卷 54-54页

作者： Brachet C. Vermeulen J. heinrichs C. 虎小毅 hpital universitaire des enfants reine fabiola 15 av. J.J. Crocq 1020 Brussels Belgium

We report severe virilization in three unrelated children by contact with their fathers,who had been using a testosterone lipogel.

关键词：睾丸酮使用史

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新生儿疼痛:认识程度与实际情况间的差异

世界核心医学期刊文摘（儿科学分册） 2006年第2期2卷 11-11页

作者： Smeesters P.R. Johansson A.B. Coppens S. 李开 Unitéde Néonatologie Intensive Hpital Universitaire des Enfants-Reine-Fabiola ULB avenue J.J.-Crocq n 15 1020 Bruxelles Belgium

A newborn hospitalized in neonatology suffers a lot of painful and fully perceived procedures. however this pain is not enough taken into consideration. There are various reasons for this failure. The objective of our study was to analyze the perception of 3 groups of participants (parents, nurses and doctors) about newborns’ pain. We wanted to compare these perceptions with pain scales (EDIN and BBdol scale) and to study their connection with newborn illness severity and mortality risk scores (SNAP and CRIB). Population and method. -We have led a prospective study involving 80 newborns. Questionnaires assessing, with the help of a visual analogic scale, the pains’ perception and the efficiency of the treatment of this pain were given to the 3 groups of participants. Results. -Parents assessed that their newborn feels an important pain (median: 5/10), that was not correlated with pain scales. Nurses and doctors assessed a lower level of pain (median: 2/10), greatly correlated with the pain scales. Parents assessed that the treatment of pain was better when the newborn was severily ill. The nurses, and even more the doctors, assessed the opposite effect. The nurses appeared to hold an intermediate position between parents and doctors. Nurses underlined moreover some lack of communication of the doctors about the newborns’ pain. This communication problem is a major hindrance to the adequate treatment of pain.

关键词：新生儿疼痛实际情况认识程度疼痛评分疾病严重程度疼痛治疗视觉模拟量表前瞻性研究受试者新生儿科