RESUMEN
OBJECTIVE: To find the existence of early relationships between alterations in the glucidic metabolism and the glomerular and tubular basal function in diabetic insulin-dependent children without clinical evidence of diabetic nephropathy (DN). METHODS: We determined blood pressure, basal plasma concentrations of glucose, glycosilated hemoglobin and total proteins, glomerular filtration rate (GFR), and the glucose, proteins, calcium, phosphorus, uric acid, sodium, potassium and chloride excretions in diurnal, nocturnal and 24-hour urine samples in 43 diabetic children and 13 healthy controls. RESULTS: The microproteinuria mean value in all urine samples (always less than 15 micrograms/min/1.73 m.2), the GFR and blood pressure were similar in both groups. In the diabetic children, we found an inverse correlation between age and 24-hour urine microproteinuria (r-0.33; p less than 0.05) and between age and nocturnal urine microproteinuria (r-0.35; p less than 0.05). There was also a highly significant correlation between microproteinuria and the albumin/creatinine ratio in urine samples (r = 0.94, p less than 0.0001). Diabetic children showed a greater nocturnal excretion of calcium (p less than 0.05) and phosphorus (p less than 0.05). CONCLUSIONS: Our results suggest that microproteinuria, GFR and blood pressure have not served as predictors of DN in pediatric patients.
Asunto(s)
Diabetes Mellitus Tipo 1/metabolismo , Nefropatías Diabéticas/metabolismo , Factores de Edad , Glucemia/análisis , Presión Sanguínea , Calcio/orina , Niño , Preescolar , Nefropatías Diabéticas/diagnóstico , Nefropatías Diabéticas/etiología , Femenino , Predicción , Tasa de Filtración Glomerular , Humanos , Masculino , Proteinuria/diagnósticoRESUMEN
After a brief literature review, we analyze the results obtained with a retrospective study of 35 neonatal osteomyelitis diagnosed between 1-January-75 and 31-December-87. The valuated frequency was of 0.40% alive newborns. Between the antecedents, we find previous neonatal sepsis in 68% of the cases. The clinical general findings were less apparent, emphasizing among the local symptoms the pain to passive mobilization and swelling. From acute phase reactants, this study rebounds the high sensitivity of C reactive protein and globular sedimentation rate. The most frequently germ isolated was S. aureus followed by K. pneumoniae. The osteomyelitic injure was unifocal in 71% of the cases and the femur was the most probable bone to be affected. At the initial treatment we associated a beta-lactamic antibiotic with an aminoglycoside one in all cases, with surgical removal in 94%. The mortality was null, but grave arthritic sequels appeared in 14% of the patients. Finally, we propose the employance of seriated quantification of C-reactive protein in the follow-up and control of therapeutic efficiency.