Infections of the lower urinary tract are characterised by localised pain, which increases when urinating, and sometimes by cloudy or dark urine, usually without high temperatures.

Kidney infections (pyelonephritis) are characterised by high temperatures, acute local pain in the lower back, and pain or irritation when urinating.

Symptoms

Urinary tract infection is characterised by the presence of local pain (lower abdomen or lumbar region), which increases when urinating. The urine is often cloudy, or dark if it contains blood. There may be high fever, especially in the case of pyelonephritis (an infection of the upper urinary tract).

Who is affected by the condition?

It can affect people at any age, from early childhood to old age. It is more frequent among women and there are factors that make people vulnerable to it (pregnancy for women and enlarged prostate for men) as well as urological anomalies (pre-existing malformation or presence of kidney stones).

Diagnosis

Urinary infections are diagnosed by examining urine under the microscope (sediment) to see whether it contains white blood cells and/or bacteria, and by cultivating the bacteria in a microbiological culture to identify the strain and determine the most appropriate antibiotic for treatment (antibiotic susceptibility testing).

Standard treatment

Urinary tract infections are usually treated with antibiotics. Treatment is oral in the case of lower-tract infection.

For upper-tract infections (pyelonephritis) it is usually intravenous, although in some cases outpatient oral treatment may be administered.

Standard tests

The standard tests are urine sediment and culture (urine culture with antibiotic susceptibility testing). An ultrasound scan may be indicated for examining the kidney and urinary tract and identifying obstructions or kidney stones that may have brought about the infection.

Ultrasounds are also used to assess the state of the kidneys. A general analysis may also be indicated to see how the urinary tract infection is affecting the rest of the body, and specifically the renal function.

Prevention 

Urinary tract infection can be prevented by frequent urination (every 2 to 3 hours) and, above all, by avoiding the habit of holding in urine, and by going to the toilet whenever the bladder feels full, without waiting too long.

Learning is a constant part of human behavior throughout life, but the quantity and quality of knowledge acquired during the first year of life is far greater—or at least comparable—to that acquired over the rest of a lifetime. The human brain increases in weight by one gram per day during the first year, followed by the formation of neuronal connections and networks that enable social smiling at one month of age, recognition of unfamiliar people at seven months, and learning to refuse to release objects around one year of age. In parallel, motor development progresses, allowing children to walk between 12 and 16 months. As development continues, cognitive (learning) and behavioral (approach–avoidance) growth intertwine, along with social interactions with parents and siblings. Many times, it is the parents—and sometimes pediatricians—who first notice that a child seems “different” or shows behaviors that draw attention.

Symptoms

The spectrum of cognitive-behavioral disorders is very broad, as are their symptoms. In general, symptoms include not achieving cognitive or behavioral milestones within the age range considered normal. For example, not exhibiting a social smile by the second month of life or not recognizing strangers by twelve months. Cognitive-behavioral disorders often form part of a broader condition, frequently with a genetic basis that may also affect other organs.

Who is affected?

The incidence of cognitive-behavioral disorders is estimated to be between 1% and 3% of all children.

Diagnosis

Parents are often the first to notice atypical signs in development or behavior, sometimes by comparing with siblings. During routine visits, the pediatrician evaluates age-appropriate developmental skills. If further assessment is needed, pediatric neurologists and geneticists can provide a more precise diagnosis. Diagnostic tests for these disorders always include a physical examination, genetic analysis, and laboratory tests that evaluate for metabolic diseases. Neuroimaging studies may also be helpful.

Common treatments

Treatment depends on the cause of the cognitive-behavioral developmental disorder. If the cause is metabolic, effective and sometimes curative treatments may exist. If the cause is genetic, it is possible to predict the course of the condition and recommend supportive educational strategies, although fully effective treatments are not yet available.

The physical examination helps determine whether the child is reaching developmental milestones appropriate for their age.

Genetic tests detect whether there is an alteration in the patient’s genes that could explain the observed anomaly.

Laboratory tests—typically using blood or urine—help confirm or rule out abnormalities in the body’s normal metabolic pathways.

Most common tests

Pediatric neurological examination, imaging studies, metabolic laboratory tests, genetic studies based on sequencing or ultra-sequencing, and evaluation by Child Psychiatry (Pediatric Psychiatry).

Prevention

If there is a family history of cognitive-behavioral disorders, genetic counseling prior to pregnancy may be useful. The neurosensory development of children is a complex process that begins during intrauterine life and continues from the neonatal stage through childhood and adolescence. Adequate monitoring during pregnancy and childbirth is also essential to help prevent these types of disorders.