ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"> <!-- saved from url=(0041)file://\\Nazi\e\sol-end\eng-maghale-2.htm --> <HTML><HEAD> <meta http-equiv="Content-Language" content="en-us"> <TITLE>Professor Soltanzadeh</TITLE> <META http-equiv=Content-Type content="text/html; charset=unicode"> <META content="Microsoft FrontPage 5.0" name=GENERATOR> <META content=FrontPage.Editor.Document name=ProgId> <style> <!-- h1 {margin-bottom:.0001pt; text-align:left; page-break-after:avoid; direction:rtl; unicode-bidi:embed; font-size:16.0pt; font-family:"Times New Roman"; margin-left:0in; margin-right:0in; margin-top:0in} h2 {margin-bottom:.0001pt; page-break-after:avoid; font-size:14.0pt; font-family:"Times New Roman"; margin-left:0in; margin-right:0in; margin-top:0in} --> </style> </HEAD> <BODY text=#000000 vLink=#ff0000 aLink=#0000ff link=#0000ff bgProperties=fixed bgColor=#ffffff leftMargin=0 background="foriegnarticle2_files/bg4 copy.gif" topMargin=0> <DIV align=left> <TABLE height=61 cellSpacing=0 cellPadding=0 width=706 border=0> <TBODY> <TR> <TD vAlign=bottom align=justify width=166 height=1><IMG height=140 src="foriegnarticle2_files/toppage3.gif" width=166 border=0></TD> <TD width=673 background=foriegnarticle2_files/bgew.gif height=1> <DIV align=left> <TABLE height=136 cellSpacing=0 cellPadding=0 border=0 width="613"> <TBODY> <TR> <TD colSpan=4 height=46 width="290"> <P align=center><IMG height=36 src="foriegnarticle2_files/Toptext7.gif" width=255 border=0></P></TD> <TD height=46 width="50"></TD> <TD height=46 width="45"></TD> <TD height=46 width="120"></TD> <TD colSpan=2 height=46 width="118"><IMG height=40 src="foriegnarticle2_files/inkscroll.gif" width=65 align=right border=0></TD></TR> <TR> <TD height=36 width="40"><a href="tamas.htm"><IMG height=30 src="foriegnarticle2_files/But8copy.gif" width=40 border=0></a></TD> <TD height=36 width="80"><a href="karhay.htm"><IMG height=30 src="foriegnarticle2_files/But7copy.gif" width=80 border=0></a></TD> <TD height=36 width="115"><a href="tarh.htm"><IMG height=30 src="foriegnarticle2_files/b1.gif" width=115 border=0></a></TD> <TD height=36 width="55"><a href="maghale.htm"><IMG height=30 src="foriegnarticle2_files/b2.gif" width=55 border=0></a></TD> <TD height=36 width="50"><a href="kongereh.htm"><IMG height=30 src="foriegnarticle2_files/But4copy.gif" width=50 border=0></a></TD> <TD height=36 width="45"><a href="talifat.htm"><IMG height=30 src="foriegnarticle2_files/But3copy.gif" width=45 border=0></a></TD> <TD height=36 width="120"><a href="moarefi.htm"><IMG height=30 src="foriegnarticle2_files/But1copy.gif" width=120 border=0></a></TD> <TD vAlign=bottom height=36 width="84"><a href="index.htm"><IMG height=30 src="foriegnarticle2_files/But10copy.gif" width=80 border=0></a>&nbsp;</TD> <TD height=36 width="34">&nbsp;&nbsp;&nbsp;&nbsp;</TD></TR> <TR> <TD align=left colSpan=9 height=54 width="623"> &nbsp;</TD></TR></TBODY></TABLE></DIV></TD></TR> <TR> <TD vAlign=top align=justify width=166 height=180><IMG height=174 src="foriegnarticle2_files/toppage1.gif" width=114 align=top border=0></TD> <TD width=673 height=180> <p class="MsoNormal" align="center" style="text-align: left; direction: ltr; unicode-bidi: embed"> <b><font size="4">Reliability of the Urinalysis for Predicting Urinary<br> Tract Infections in Young Febrile Children</font></b></p> <DIV align=left> <TABLE cellSpacing=0 cellPadding=4 width=587> <TBODY> <TR> <TD width="579"> <p class="MsoNormal" style="text-align:left;direction:ltr;unicode-bidi:embed"> <font color="#000080"><br> Richard Bachur , MD; Marvin B. Harper , MD </font></p> <p class="MsoBodyText" style="text-align:justify;text-justify:kashida;text-kashida: 0%;direction:ltr;unicode-bidi:embed"><font color="#620000"><b>Bachground: </b> </font>Urinary tract infections (Utls) are a common source of bacterial infection among younge febrile children. Clinical variables affecting the sensitivity of the urinalysis (UA) as a screen for UTI have not been previously investigated. The limited sensitivity of the UA for detecting a UTI requires that a urine culture be obtained in some children regardless of the UA result; however, a proper urine culture requires an invasive procedure, so the criteria for its use should be optimized.</p> <p class="MsoNormal" style="text-align:justify;text-justify:kashida;text-kashida: 0%;direction:ltr;unicode-bidi:embed"><font color="#620000"><b>Objectives:</b></font> To determine how the sensitivity of the standard UA as a screening test for UTI varies with age, and to determine the clinical situation that necessitates the collection of a urine culture regardless of the UA result.</p> <p class="MsoNormal" style="text-align:justify;text-justify:kashida;text-kashida: 0%;direction:ltr;unicode-bidi:embed"><font color="#620000"><b>Methods:</b></font> Retrospective medical record review of patients younger than 2 years with fever (&gt;38C) seen in the emergency department during a period of 65 months. All urine cultures were reviewed for the collection method , isolates , and colony counts. A UA result was considered positive if the presence of &nbsp;l of the following was detected: leukocyte esterase , nitrite , or pyuria (&gt;5 white blood cells per high power field ). Patients who had a paired UA and urine culture were used to calculate the sensitivity , specificity , and likelihood ratios of the UA. The prevalence of UTIs was also subcategorized by age, race , sex , and fever.</p> <p class="MsoNormal" style="text-align:justify;text-justify:kashida;text-kashida: 0%;direction:ltr;unicode-bidi:embed"><font color="#620000"><b>Results:</b></font> Medical records of 37450 febrile children younger than 2 years were reviewed . Forty  four percent were girls . Median age and temperature were 10.6 month and 38.8C .A total of 11089 patients (30%) had urine cultures obtained. The sensitivity of the UA was 82% (95% confidence&nbsp; interval [ CI], 79%-84%) and did not vary by age subgroups . The specificity of UA was 92% (95% CI , 91%-92%) . The likelihood ratios for a positive UA and negative UA were 10.6 (95%CI , 10.0-11.2) and 0.19(95%CI , 0.18-0.20) , respectively , Prevalence of UTI was 2.1% overall (2.9% for girls and 1.5% for boys , respectively).Among girls, the prevalence of UTI was 5.0% in white patients , 2.1% in Hispanic patients , and 1.0% in black patients . Among boys , the prevalence was 2.2% in Hispanic patients , 1.4% in white patients , and 0.8% in black patients . Higher prevalence was also seen among patients with a temperature at or above 39C compared with those whose tempearature was between 38.0C and 38.9C .The greatest prevalence of UTI (13%) was found among&nbsp; white girls younger than 6 months with a temperature at or greater than 39C.&nbsp; The posttest probability of a UTI in the presence of a negative UA can be calculated using the negative likelihood ratio and the patient-specific preva-lence of UTI . When the prevalence of UTI is 2%, l UA among 250 will produce a false-negative test result.<TR> <TD width="579"> <hr> <p class="MsoNormal" style="text-align: left; text-kashida: 0%; direction: ltr; unicode-bidi: embed"> <font color="#007500"><b>Jama Pediatrics <br> May/ June 2001</b></font></TR></TBODY></TABLE></DIV><BR> <DIV align=left> <TABLE height=67 cellSpacing=0 cellPadding=0 width=599 border=0> <TBODY> <TR> <TD width=579 height=65> <P class=MsoNormal dir=rtl style="MARGIN-BOTTOM: -15px; DIRECTION: rtl; unicode-bidi: embed; mso-pagination: none; mso-layout-grid-align: none" align=center><a href="Index.htm">Home page</a>&nbsp; |&nbsp;<a href="eng-moarefi.htm">Introduction</a>&nbsp;|&nbsp;<a href="eng-tarh.htm"> Research Studies</a>&nbsp; |&nbsp;<a href="eng-talifat.htm"> Editorships</a>&nbsp; |&nbsp;<a href="eng-translate.htm"> Translations</a>&nbsp; |&nbsp;<a href="eng-kongereh.htm"> Conferences</a>&nbsp; </P> <P class=MsoNormal dir=rtl style="MARGIN-BOTTOM: -15px; DIRECTION: rtl; unicode-bidi: embed; mso-pagination: none; mso-layout-grid-align: none" align=center><a href="eng-tamas.htm">Contact Information</a>&nbsp; |&nbsp;<a href="eng-maghale.htm"> Articles</a>&nbsp; |&nbsp;<a href="news.htm"> Scientific meets &amp; events</a>&nbsp; |&nbsp;<a href="research.htm"> Research projects</a>&nbsp; |&nbsp; Theses</P></TD></TR></TBODY></TABLE></DIV></TD></TR></TBODY></TABLE></DIV></BODY></HTML>