The kidneys play a critical role in maintaining glucose homeostasis.Under normal renal tubular function,most of the glucose filtered from the glomeruli is re-absorbed in the proximal tubules,leaving only trace amounts...The kidneys play a critical role in maintaining glucose homeostasis.Under normal renal tubular function,most of the glucose filtered from the glomeruli is re-absorbed in the proximal tubules,leaving only trace amounts in the urine.Glycosuria can occur as a symptom of generalized proximal tubular dysfunction or when the reabsorption threshold is exceeded or the glucose threshold is reduced,as seen in familial renal glycosuria(FRG).FRG is characterized by persistent glycosuria despite normal blood glucose levels and tubular function and is primarily associated with mutations in the sodium/glucose cotransporter 5A2 gene,which encodes the sodium-glucose cotransporter(SGLT)2.Inhibiting SGLTs has been proposed as a novel treatment strategy for diabetes,and since FRG is often considered an asymptomatic and benign condition,it has inspired preclinical and clinical studies using SGLT2 inhibitors in type 2 diabetes.However,patients with FRG may exhibit clinical features such as lower body weight or height,altered systemic blood pressure,diaper dermatitis,amino-aciduria,decreased serum uric acid levels,and hypercalciuria.Further research is needed to fully understand the pathophysiology,molecular genetics,and clinical manifestations of renal glucosuria.展开更多
AIM To investigate different etiologies and management of the rhabdomyolysis in children.METHODS Eight pediatric rhabdomyolysis cases who applied to the Dokuz Eylul University Faculty of Medicine Department of Pediatr...AIM To investigate different etiologies and management of the rhabdomyolysis in children.METHODS Eight pediatric rhabdomyolysis cases who applied to the Dokuz Eylul University Faculty of Medicine Department of Pediatric Nephrology with different etiologies between January 2004 and January 2012 were evaluated in terms of age, gender, admission symptoms, physical examination findings, factors provoking rhabdomyolysis, number of rhabdomyolysis attacks, laboratory results, family history and the final diagnosis received after the treatment. RESULTS Average diagnosis ages of eight cases were 129(24-192) ± 75.5 mo and five of them were girls. All of them had applied with the complaint of muscle pain, calf pain, and dark color urination. Infection(pneumonia) and excessive physical activity were the most important provocative factors and excessive licorice consumption was observed in one case. In 5 cases, acute kidney injury was determined and two cases needed hemodialysis. As a result of the further examinations; the cases had received diagnoses of rhabdomyolysis associated with mycoplasma pneumoniae, sepsis associated rhabdomyolysis, licorice-induced hypokalemic rhabdomyolysis, carnitine palmitoyltransferase Ⅱ deficiency, very long-chain acyl-CoA dehydrogenase deficiency, congenital muscular dystrophy and idiopathic paroxysmal rhabdomyolysis(Meyer-Betz syndrome).CONCLUSION It is important to distinguish the sporadic and recurrent rhabdomyolysis cases from each other. Recurrent rhabdomyolysis cases should follow up more regardful and attentive.展开更多
Background:Vulvovaginitis is the most common cause of gynecological complaints in children and young girls.Some of the factors which cause vulvovaginitis include hypoestrogenism,the anatomical proximity of rectum and ...Background:Vulvovaginitis is the most common cause of gynecological complaints in children and young girls.Some of the factors which cause vulvovaginitis include hypoestrogenism,the anatomical proximity of rectum and delicate vulvar skin and vaginal mucosa.Data sources:We made a literature search with Pubmed,Medline and Cochrane database from January 2002 to May 2015 in English language using the key words vulvovaginitis,children,clinical,diagnosis and treatment.Results:Vulvovaginitis in girls is usually caused by non-specific factors and hygiene measures,bioyoghurt and avoidance of chemical irritants are generally useful.Weight control if necessary and prevention of voiding dysfunction are effective.Vaginal flora is important in girls and results should be interpreted with clinical features to decide whether an isolated microorganism is part of the normal microflora or is the cause of symptomatic vulvovaginitis.Specific treatment is generally considered in case of a detected pathogen microorganism.Isolation of a sexually transmitted organism requires further investigation.Persistent disease may not always indicate a foreign body but it must be taken into account.Girls and parents are encouraged psychologically in all steps of evaluation,diagnosis and treatment.Probiotics,nanotechnology and petroleum jelly are other important treatment options used in vulvovaginitis.Conclusions:In this review,we present current approach to the presentation and management of vulvovaginitis in childhood.This disorder requires a comprehensive evaluation in all steps of diagnosis,differential diagnosis and treatment.展开更多
文摘The kidneys play a critical role in maintaining glucose homeostasis.Under normal renal tubular function,most of the glucose filtered from the glomeruli is re-absorbed in the proximal tubules,leaving only trace amounts in the urine.Glycosuria can occur as a symptom of generalized proximal tubular dysfunction or when the reabsorption threshold is exceeded or the glucose threshold is reduced,as seen in familial renal glycosuria(FRG).FRG is characterized by persistent glycosuria despite normal blood glucose levels and tubular function and is primarily associated with mutations in the sodium/glucose cotransporter 5A2 gene,which encodes the sodium-glucose cotransporter(SGLT)2.Inhibiting SGLTs has been proposed as a novel treatment strategy for diabetes,and since FRG is often considered an asymptomatic and benign condition,it has inspired preclinical and clinical studies using SGLT2 inhibitors in type 2 diabetes.However,patients with FRG may exhibit clinical features such as lower body weight or height,altered systemic blood pressure,diaper dermatitis,amino-aciduria,decreased serum uric acid levels,and hypercalciuria.Further research is needed to fully understand the pathophysiology,molecular genetics,and clinical manifestations of renal glucosuria.
文摘AIM To investigate different etiologies and management of the rhabdomyolysis in children.METHODS Eight pediatric rhabdomyolysis cases who applied to the Dokuz Eylul University Faculty of Medicine Department of Pediatric Nephrology with different etiologies between January 2004 and January 2012 were evaluated in terms of age, gender, admission symptoms, physical examination findings, factors provoking rhabdomyolysis, number of rhabdomyolysis attacks, laboratory results, family history and the final diagnosis received after the treatment. RESULTS Average diagnosis ages of eight cases were 129(24-192) ± 75.5 mo and five of them were girls. All of them had applied with the complaint of muscle pain, calf pain, and dark color urination. Infection(pneumonia) and excessive physical activity were the most important provocative factors and excessive licorice consumption was observed in one case. In 5 cases, acute kidney injury was determined and two cases needed hemodialysis. As a result of the further examinations; the cases had received diagnoses of rhabdomyolysis associated with mycoplasma pneumoniae, sepsis associated rhabdomyolysis, licorice-induced hypokalemic rhabdomyolysis, carnitine palmitoyltransferase Ⅱ deficiency, very long-chain acyl-CoA dehydrogenase deficiency, congenital muscular dystrophy and idiopathic paroxysmal rhabdomyolysis(Meyer-Betz syndrome).CONCLUSION It is important to distinguish the sporadic and recurrent rhabdomyolysis cases from each other. Recurrent rhabdomyolysis cases should follow up more regardful and attentive.
文摘Background:Vulvovaginitis is the most common cause of gynecological complaints in children and young girls.Some of the factors which cause vulvovaginitis include hypoestrogenism,the anatomical proximity of rectum and delicate vulvar skin and vaginal mucosa.Data sources:We made a literature search with Pubmed,Medline and Cochrane database from January 2002 to May 2015 in English language using the key words vulvovaginitis,children,clinical,diagnosis and treatment.Results:Vulvovaginitis in girls is usually caused by non-specific factors and hygiene measures,bioyoghurt and avoidance of chemical irritants are generally useful.Weight control if necessary and prevention of voiding dysfunction are effective.Vaginal flora is important in girls and results should be interpreted with clinical features to decide whether an isolated microorganism is part of the normal microflora or is the cause of symptomatic vulvovaginitis.Specific treatment is generally considered in case of a detected pathogen microorganism.Isolation of a sexually transmitted organism requires further investigation.Persistent disease may not always indicate a foreign body but it must be taken into account.Girls and parents are encouraged psychologically in all steps of evaluation,diagnosis and treatment.Probiotics,nanotechnology and petroleum jelly are other important treatment options used in vulvovaginitis.Conclusions:In this review,we present current approach to the presentation and management of vulvovaginitis in childhood.This disorder requires a comprehensive evaluation in all steps of diagnosis,differential diagnosis and treatment.
