Revue médicale de la Suisse romande
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The assessment of glomerular filtration rate (GFR) is critical for the diagnosis and management of renal diseases in pediatric nephrology. Ideally, it requires the measurement of the renal clearance of a filtration marker. Inulin, an exogenous marker, is the only compound the excretion of which occurs exclusively by glomerular filtration, with no tubular handling. ⋯ Mathematical formulas taking these parameters into account have thus been developed. Among these, the so-called "Schwartz formula" is often used and is a reliable estimate of GFR in children. Finally, radionuclide renal scans can be used to evaluate the separate glomerular function of each kidney.
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Rev Med Suisse Romande · Dec 2002
Review[Ambulatory parenteral antibiotics in the treatment of severe pediatric infections].
The indications to parenteral antibiotic treatment in paediatrics are frequent. Antibiotic agents with antimicrobial spectrums and pharmacodynamic properties allowing effective and secure outpatient parenteral therapy are now widely available. ⋯ The physician responsible for conducting such treatment should select patients according to strict criteria and never neglect security and quality issues. In this article, the authors discuss different aspects (general, medical, psychosocial, economic and practical) related to outpatient parenteral antibiotic treatment of severe paediatric infections.
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Idiopathic ketotic hypoglycemia is the most frequent cause of hypoglycemia in children between 1 and 5 years of age. The symptoms and signs of hypoglycemia are often overlooked because they mimic signs of other common diseases like psychiatric disorders, migraine, gastro-enterological dysfunction, or visual disturbances. Glycemia and ketone bodies in the urine should be systematically investigated in such cases. ⋯ Infants with normal growth and psychomotor development, normal physical examination who present with a first episode of symptomatic fasting hypoglycemia and elevated ketonuria, and who improve quickly after intravenous glucose administration, do not need a comprehensive metabolic and endocrine workup. Recurrence of hypoglycemic attacks can be prevented by supplying frequent snacks containing complex carbohydrates, so called "slow sugars", particularly at bed-time. Other causes of ketotic hypoglycemia are briefly presented.