Hallazgos gammagráficos de lactantes con criterios de JODAL para Pielonefritis aguda en el Hospital niño Jesús de Barranquilla 2017-2018
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Fecha
2019
Autores
Álvarez Sánchez, Francisco
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
Introducción La infección de tracto urinario (ITU) tiene una alta incidencia durante la infancia apareciendo en cerca de 7% de los niños febriles menores de un año y es un indicador de anomalías anatómicas, como el reflujo vesicoureteral (RVU). El diagnóstico oportuno de una ITU y su tratamiento adecuado pueden prevenir complicaciones a corto plazo como una pielonefrítis severa o sepsis de origen urinario que aparece hasta en 30% de recién nacidos y 20% en lactantes menores de tres meses. Objetivo: Determinar los hallazgos gamma gráficos de lactantes en el contexto de primer episodio documentado de pielonefrítis clínica. Método: Retrospectivo analítico, de concordancia diagnóstica entre los criterios de Jodal y la gammagrafía renal con DMSA, en pacientes menores de 2 años. Se revisaron 237 historias clínicas, mediante el sistema informativo SIOS con el código CIE-10: N390 (Infección de vías urinarias), de las cuales 131 cumplían criterios de inclusión en un periodo de 18 meses. Resultados: El nivel de concordancia encontrada en el presente estudio fue débil, lo cual contrasta con un trabajo similar de Moreno y cols que mostró una sensibilidad de 86,7% y especificidad de 53,8%, igualmente a lo reportado por J. Lafaurie como donde el desempeño fue menor que el reportado por Moreno y cols. Se evidencio estadísticamente una asociación entre una Leucocitosis mayor de 20.000 y el diagnóstico de pielonefrítis con un (p=0.006), así mismo, entre los valores el PCR mayor de 20mg/l y el diagnóstico de pielonefrítis con un p-valor (p=0.023), esta asociación coincide con los reportes de C. Gonzalo, M. Méndez & M. Azuara(39), Conclusiones: La concordancia entre los criterios de Jodal y la gammagrafía en el diagnóstico de PNA fue débil en la población estudio. Son necesarios nuevos estudios que evalúen el desempeño de estos criterios de manera prospectiva y multicéntrica.
Introduction Introduction Urinary tract infection (UTI) has a high incidence during childhood, appearing in about 7% of febrile children under one year of age and is an indicator of anatomical anomalies, such as vesicoureteral reflux (VUR) (3). The timely diagnosis of a UTI and its adequate treatment can prevent short-term complications such as severe pyelonephritis or sepsis of urinary origin that appears in up to 30% of newborns and 20% in infants under three months of age (1-3). Objective: To determine the graphic gamma findings of infants in the context of the first documented episode of clinical pyelonephritis. Method: Analytical retrospective, of diagnostic agreement between Jodal criteria and renal scintigraphy with DMSA, in patients younger than 2 years. We reviewed 237 clinical histories, through the SIOS information system with the code ICD-10: N390 (Urinary tract infection), of which 131 met the inclusion criteria in a period of 18 months. Results: The level of concordance found in the present study was weak, which contrasts with a similar work by Moreno et al (38) who showed a sensitivity of 86.7% and specificity of 53.8%, similar to that reported by J. Lafaurie as where performance was lower than that reported by Moreno et al. Statistically, an association was found between a leukocytosis greater than 20,000 and the diagnosis of pyelonephritis with a (p = 0.006), likewise, between the CRP values higher than 20mg / l and the diagnosis of pyelonephritis with a p-value (p = 0.023). ), this association coincides with the reports of C. Gonzalo, M. Méndez & M. Azuara (39), Conclusions: The concordance between Jodal's criteria and scintigraphy in the diagnosis of PNA was weak in the study population. New studies that evaluate the performance of these criteria in a prospective and multicentric manner are necessary. Key words: Acute pyelonephritis, Gammagraphy, Jodal criteria.
Introduction Introduction Urinary tract infection (UTI) has a high incidence during childhood, appearing in about 7% of febrile children under one year of age and is an indicator of anatomical anomalies, such as vesicoureteral reflux (VUR) (3). The timely diagnosis of a UTI and its adequate treatment can prevent short-term complications such as severe pyelonephritis or sepsis of urinary origin that appears in up to 30% of newborns and 20% in infants under three months of age (1-3). Objective: To determine the graphic gamma findings of infants in the context of the first documented episode of clinical pyelonephritis. Method: Analytical retrospective, of diagnostic agreement between Jodal criteria and renal scintigraphy with DMSA, in patients younger than 2 years. We reviewed 237 clinical histories, through the SIOS information system with the code ICD-10: N390 (Urinary tract infection), of which 131 met the inclusion criteria in a period of 18 months. Results: The level of concordance found in the present study was weak, which contrasts with a similar work by Moreno et al (38) who showed a sensitivity of 86.7% and specificity of 53.8%, similar to that reported by J. Lafaurie as where performance was lower than that reported by Moreno et al. Statistically, an association was found between a leukocytosis greater than 20,000 and the diagnosis of pyelonephritis with a (p = 0.006), likewise, between the CRP values higher than 20mg / l and the diagnosis of pyelonephritis with a p-value (p = 0.023). ), this association coincides with the reports of C. Gonzalo, M. Méndez & M. Azuara (39), Conclusions: The concordance between Jodal's criteria and scintigraphy in the diagnosis of PNA was weak in the study population. New studies that evaluate the performance of these criteria in a prospective and multicentric manner are necessary. Key words: Acute pyelonephritis, Gammagraphy, Jodal criteria.
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Pielonefrítis aguda, Gammagrafía, Criterios de Jodal, Acute pyelonephritis, Gammagraphy, Jodal criteria
