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04/03/ · After the earthquake, Zanmi Lasante, the Haitian branch of Partners in Health, became the largest and one of the most important health care providers in nolazhe.институтдиетологии.рф by: Created Date: 2/22/ PM. 26/08/ · Perspective from The New England Journal of Medicine — Can We Treat Cancer for a Dollar a Day? Guidelines for Low-Income CountriesCited by: American Academy of Pediatrics – Section on Nephrology and the American Society of Pediatric Nephrology Five Things Physicians and Patients Should Question. ijb jZaebqguo ikbobq_kdbo jZkkljhckl\Zo bgZ jZaebqguo mjh\gyo hj]ZgbaZpbb ebqghklb D_jg[kj] i_j_kfZljb\Z_l ikbohZgZeblbq_kdmx l_hjbx Znn_dlh\ bl_hjbx g_gZ\bklb dZd.

Research has shown a high incidence of misinterpretation of positive tests of screening urinalysis lead to multiple testing and increased cost and family anxiety.

This is counterbalanced by the low prevalence of chronic kidney disease CKD and bladder cancer in children. With consideration of the currently available evidence, we recommend limiting screening UA in patients who are at high risk for chronic kidney disease CKD , including but not necessarily limited to patients with a personal history of CKD, acute kidney injury AKI , congenital anomalies of the urinary tract, acute nephritis, hypertension HTN , active systemic disease, prematurity, intrauterine growth retardation, or a family history of genetic renal disease, to improve the cost-benefit ratio.

Do not initiate a work up for hematuria or proteinuria before repeating an abnormal urine dipstick analysis UA.

Abnormal dipstick urine analyses UA need to be repeated due to the high incidence of false positive tests.

Russian abstract

Abnormal urine testing results are often due to difficulties in obtaining a non-contaminated urine specimen or transient abnormalities seen with acute illnesses. Repeating a UA prior to initiation of a full evaluation can decrease the need for additional testing, as described below:.

Avoid ordering follow-up urine cultures after treatment for an uncomplicated urinary tract infection UTI in patients that show evidence of clinical resolution of infection. Studies have shown that clinical resolution of infection is adequate for determining effectiveness of antibiotic therapy after treatment for a UTI.

Do not initiate an outpatient hypertension HTN work-up in asymptomatic pediatric patients prior to repeating the blood pressure measurement. Blood pressures in children need to be taken in accordance with standard methodology prior to the diagnosis of HTN in order to decrease the number of false positive readings that are often seen in pediatric patients.

Methodology should include assessment of blood pressure in the upper extremity, by manual auscultation, with an appropriate-sized cuff.

NHLBI and AAP guidelines recommend repeating blood pressures BP x 3 at the same visit and at 2 additional visits to document persistent BP elevation prior to initiating a work up for pediatric hypertension HTN due to the possibility of falsely elevated BP readings in children as the prevalence of elevated blood pressures decreases significantly on repeated measures.

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Preservation of vascular access is critical for long-term dialysis patients. Placement of central and PICC lines has been associated with an increased incidence of complications including vascular injury, thrombosis and central venous stenosis that can limit future use for dialysis access.

Placement of central and PICC lines also potentially increases cost due to the treatment of complications from the lines, requirement for radiological tests to identify patent vessels for dialysis, and the necessity for repeat surgical procedures to create vascular access for dialysis.

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Studies in children are limited, but research about PICC lines demonstrates a percent incidence of thrombosis in adults and increased complications in children who are exposed to multiple PICC line placements.

Studies from adult patients have demonstrated the high risk of vascular injury after central line and PICC line placement. Special consideration may be necessary in emergency circumstances in which no other safe access is achievable.

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  • These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician. The American Academy of Pediatrics is an organization of 68, primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

    For more information, visit www. The American Society of Pediatric Nephrology ASPN is a professional society composed of pediatric nephrologists whose goal is to promote optimal care for children with kidney disease and to disseminate advances in the clinical practice and basic science of pediatric nephrology.

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    First, the two groups independently developed lists based on various common assessments, evaluations, and treatments in the practice of pediatric nephrology. During the second stage, the committee chairs consolidated the lists and then re-convened the individual committees to narrow the topics on the list.

    During the third stage, a final list of five practices was developed and consensus achieved by both committees that were found to be supported by evidence.

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  • Recommendations for preventive pediatric health care. Pediatrics ; 6 : Screening dipstick urinalysis: a time to change.

    Sekhar DL, Wang L,. Pediatrics 4 ; — Hogg, R. Clin J Am Soc Neph Meyers KEC: Evaluation of hematuria in children. Urol Clin North Amer , Pediatr Clin North Amer , J Pediatr , Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children.

    English abstract

    Pediatrics , Bachir R: Nonresponders: prolonged fever among infants with urinary tract infections. Pediatrics E59, Follow-up urine cultures and fever in children with urinary tract infection.

    Arch Pediatr Adolesc Med , Hypertens Res. Pediatrics 14, , J Vasc Interv Radiol , Minimizing complications associated with percutaneous central venous catheter placement in children: recent advances.

    Pediatr Crit Care Med ; — Clin J Amer Soc Nephrol 11 : , Forauer AR, Theoharis C: Histologic changes in the human vein wall adjacent to indwelling central venous catheters.

    Repeating a UA prior to initiation of a full evaluation can decrease the need for additional testing, as described below: Repeat a clean catch UA with microscopy x 3 for patients noted to have microscopic hematuria to look for evidence of chronic hematuria.