%0 Journal Article %J World J Clin Pediatr %D 2016 %T Acute lobar nephritis in children: Not so easy to recognize and manage. %A Bibalo, Cristina %A Apicella, Andrea %A Guastalla, Veronica %A Marzuillo, Pierluigi %A Zennaro, Floriana %A Tringali, Carmela %A Taddio, Andrea %A Germani, Claudio %A Barbi, Egidio %X

Acute lobar nephritis (ALN) is a localized non-liquefactive inflammatory renal bacterial infection, which typically involves one or more lobes. ALN is considered to be a midpoint in the spectrum of upper urinary tract infection, a spectrum ranging from uncomplicated pyelonephritis to intrarenal abscess. This condition may be difficult to recognize due to the lack of specific symptoms and laboratory findings. Therefore the disease is probably underdiagnosed. Computed tomography scanning represents the diagnostic gold standard for ALN, but magnetic resonance imagine could be considered in order to limit irradiation. The diagnosis is relevant since initial intravenous antibiotic therapy and overall length of treatment should not be shorter than 3 wk. We review the literature and analyze the ALN clinical presentation starting from four cases with the aim to give to the clinicians the elements to suspect and recognize the ALN in children.

%B World J Clin Pediatr %V 5 %P 136-42 %8 2016 Feb 8 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/26862513?dopt=Abstract %R 10.5409/wjcp.v5.i1.136 %0 Journal Article %J Arch Dis Child %D 2014 %T Diagnostic accuracy of ultrasonography for hand bony fractures in paediatric patients. %A Neri, Elena %A Barbi, Egidio %A Rabach, Ingrid %A Zanchi, Chiara %A Norbedo, Stefania %A Ronfani, Luca %A Guastalla, Veronica %A Ventura, Alessandro %A Guastalla, Pierpaolo %K Adolescent %K Child %K Child, Preschool %K Cross-Sectional Studies %K Double-Blind Method %K Emergency Service, Hospital %K Female %K Fractures, Bone %K Hand Bones %K Humans %K Italy %K Male %K Sensitivity and Specificity %X

OBJECTIVE: Hand fractures are common in childhood, and radiography is the standard diagnostic procedure. US has been used to evaluate bone injuries, mainly in adults for long-bone trauma; there are only a few studies about hand fractures in children. The purpose of this study was to evaluate and confirm the safety and applicability of the US diagnostic procedure in comparison to X-ray diagnosis.

STUDY DESIGN: This cross-sectional study involved a convenience sample of young patients (between 2 and 17 years old) who were taken to the emergency department due to hand trauma. After clinical assessment, patients with a suspected hand fracture first underwent X-ray, and subsequently US examination by two different operators; a radiologist experienced in US and a trained emergency physician in "double-blind" fashion. US and radiographic findings were then compared, and sensitivity as well as specificity was calculated.

RESULTS: A total of 204 patients were enrolled in the study. Seventy-nine fractures of phalanges or metacarpals were detected by standard radiography. When US imaging was performed by an expert radiologist, 72 fractures were detected with sensitivity and a specificity of 91.1% and 97.6%, respectively. Sensitivity and specificity were found to be (respectively) 91.5% and 96.8% when US was performed by the ED physicians.

CONCLUSIONS: US imaging showed excellent sensitivity and specificity results in the diagnosis of hand fractures in children. The study also showed a great agreement between the results of the US carried out by the senior radiologist and those carried out by the paediatric emergency physician, suggesting that US can be performed by an ED physician, allowing a rapid and accurate evaluation in ED and could become the first diagnostic approach whenever a hand fracture is suspected.

%B Arch Dis Child %V 99 %P 1087-90 %8 2014 Dec %G eng %N 12 %1 http://www.ncbi.nlm.nih.gov/pubmed/24951462?dopt=Abstract %R 10.1136/archdischild-2013-305678