73 research outputs found
Isolated Fetal Ascites Secondary to Persistent Urogenital Sinus
Objective. To present a case of isolated ascites secondary due to urogenital abnormalities (urogenital sinus) without any other prenatal ultrasound marker. Method. A 36-year-old woman with prenatal isolated ascites delivered a female baby, weighing 2.285 g; ascites was drained at birth and the baby underwent several episodes of urinary retention prior to undergoing X-ray investigations. Results. A voiding cystourethrogram revealed a short urogenital sinus: a vesicostomy was performed. A vaginoscopy revealed double vagina with a large posterior vagina. A posterior sagittal anorectal pull-through with genitoplasty was performed at 2 years old with 1-year follow-up. Conclusions. Though rare, a urogenital abnormality is to be suspected in fetal ascites cases with negative viral tests and no cardiac anomalies. The most common ultrasound marker of such abnormalities (fluid filled cavity) may be missing because of complete drainage of urine through the tubes into peritoneum
A 20-year study of persistence of lower urinary tract symptoms and urinary incontinence in young women treated in childhood
OBJECTIVE: To determine whether urinary incontinence (UI) and lower urinary tract symptoms (LUTS) persist over years, patients treated for UI and LUTS in childhood were re-evaluated in adulthood.
MATERIALS AND METHODS:
Forty-seven women (cases) treated in childhood for daytime UI/LUTS (group A) and nocturnal enuresis (group B) self-completed (average age: 24.89 ± 3.5 years) the International Consultation on Incontinence Questionnaire for Female with LUTS (ICIQ-FLUTS). ICIQ-FLUTS was self-administered to 111 healthy women (average age: 23 ± 5.1 years) from a nursing school as a control group. Data obtained from ICIQ-FLUTS and quality of life (QoL) score (0-10) were compared (Fisher's exact test) between patients and controls, and between group A (n = 28) and group B (n = 19).
RESULTS:
Prevalence of LUTS was higher in patients than in controls. The difference between patients and controls was statistically significant (p = 0.0001) for UI (34% vs. 7%) and feeling of incomplete bladder emptying (49% vs. 28%). QoL score was >5 in 59% of patients and 1% of controls (p = 0.0001). No significant differences were found between groups A and B.
CONCLUSIONS:
UI and LUTS are confirmed in young women who suffered for the same condition in childhood. Longitudinal studies are needed to assess if these symptoms persist or are newly onset
Lower Urinary Tract Dysfunction in Pediatric Patients with Multiple Sclerosis: Diagnostic and Management Concerns
background: multiple sclerosis (MS) is increasing in the pediatric population and, as in adults, symptoms vary among patients. in children the first manifestations can sometimes overlap with acute neurological symptoms. urological symptoms have not been much studied in childhood. we shared our experience with MS urological manifestation in children. methods: this article is a retrospective evaluation of all children with MS, according to the Krupp criteria, who also present with urological symptoms. we collected demographic and clinical history, the MR localization of demyelinating lesions, urological symptoms, and exams. results: we report on six MS pediatric cases with urological manifestation. urinary symptoms, characterized by urinary incontinence in five patients and urinary retention in one patient, appeared in a different time frame from MS diagnosis. urodynamic exams showed both overactive and underactive bladder patterns. treatment was defined according to lower urinary tract dysfunction, using clean intermittent catheterization, oxybutynin, and intradetrusor onabotulinum toxin-a injection. a low acceptance rate of invasive evaluation and urological management was observed. conclusions: the MS diagnosis was traumatic for all our patients. we believe it is important to address urological care in young people from the time of diagnosis for prompt management; it could be useful to include a pediatric urologist in multidisciplinary teams
Case Report Isolated Fetal Ascites Secondary to Persistent Urogenital Sinus
Objective. To present a case of isolated ascites secondary due to urogenital abnormalities (urogenital sinus) without any other prenatal ultrasound marker. Method. A 36-year-old woman with prenatal isolated ascites delivered a female baby, weighing 2.285 g; ascites was drained at birth and the baby underwent several episodes of urinary retention prior to undergoing X-ray investigations. Results. A voiding cystourethrogram revealed a short urogenital sinus: a vesicostomy was performed. A vaginoscopy revealed double vagina with a large posterior vagina. A posterior sagittal anorectal pull-through with genitoplasty was performed at 2 years old with 1-year follow-up. Conclusions. Though rare, a urogenital abnormality is to be suspected in fetal ascites cases with negative viral tests and no cardiac anomalies. The most common ultrasound marker of such abnormalities (fluid filled cavity) may be missing because of complete drainage of urine through the tubes into peritoneum
Consensus review of best practice of transanal irrigation in adults
Study design: Review article.
Objectives: To provide a consensus expert review of the treatment modality for transanal irrigation (TAI).
Methods: A consensus group of specialists from a range of nations and disciplines who have experience in prescribing and monitoring
patients using TAI worked together assimilating both the emerging literature and rapidly accruing clinical expertise. Consensus was
reached by a round table discussion process, with individual members leading the article write-up in the sections where they had particular expertise.
Results: Detailed trouble-shooting tips and an algorithm of care to assist professionals with patient selection, management and follow-up was developed.
Conclusion: This expert review provides a practical adjunct to training for the emerging therapeutic area of TAI. Careful patient selection, directly supervised training and sustained follow-up are key to optimise outcomes with the technique. Adopting a tailored, stepped approach to care is important in the heterogeneous patient groups to whom TAI may be applied.
Sponsorship: The review was financially supported by Coloplast A/S.
Spinal Cord (2013) 51, 732–738; doi:10.1038/sc.2013.86; published online 20 August 201
Transitional Care for Patients with Congenital Colorectal Diseases: An EUPSA Network Office, ERNICA, and eUROGEN Joint Venture
Background: Transition of care (TOC; from childhood into adulthood) of patients with anorectal malformations (ARM) and Hirschsprung disease (HD) ensures continuation of care for these patients. The aim of this international study was to assess the current status of TOC and adult care (AC) programs for patients with ARM and HD. Methods: A survey was developed by members of EUPSA, ERN eUROGEN, and ERNICA, including patient representatives (ePAGs), comprising of four domains: general information, general questions about transition to adulthood, and disease-specific questions regarding TOC and AC programs. Recruitment of centres was done by the ERNs and EUPSA, using mailing lists and social media accounts. Only descriptive statistics were reported. Results: In total, 82 centres from 21 different countries entered the survey. Approximately half of them were ERN network members. Seventy-two centres (87.8%) had a self-reported area of expertise for both ARM and HD. Specific TOC programs were installed in 44% of the centres and AC programs in 31% of these centres. When comparing centres, wide variation was observed in the content of the programs. Conclusion: Despite the awareness of the importance of TOC and AC programs, these programs were installed in less than 50% of the participating centres. Various transition and AC programs were applied, with considerable heterogeneity in implementation, content and responsible caregivers involved. Sharing best practice examples and taking into account local and National Health Care Programs might lead to a better continuation of care in the future. Level of Evidence: III
Effect of Dexamethasone on Postoperative Adhesion Formation
Typescript (photocopy).Allomyces macrogynus produces uninucleate, motile gametes by the rearrangement and cleavage of the multinucleate cytoplasm of gametangia. In other aquatic fungi, a Golgi complex made up of stacked cisternae is the source of new membrane and glycoproteins formed during cytoplasmic cleavage. Allomyces does not have stacks of Golgi cisternae but instead has individual smooth endomembrane elements, termed Golgi equivalents. The objective of this study was to use an ultrastructural, pharmacological, and biochemical approach to determine the origin of cleavage furrow membrane during gametogenesis. The microdroplet culture method developed for this study gave a 1.7 to 2.4-fold higher degree of synchrony during gametogenesis. Using this method, it was possible to construct a precise timing sequence for gamete differentiation. Straining with ZnI-OsO₄ impregnation demonstrated that the endoplasmic reticulum was the origin of the nuclear cap membrane but neither the cleavage furrows nor the membrane elements which gave rise to them strained with ZnI-OsO₄. Since acidic compartments, such as trans Golgi do not stain by this method it appeared likely that cleavage furrows might be derived from Golgi equivalents. To further test the hypothesis that Golgi equivalents were involved in cleavage, induced gametangia were treated with monensin, an ionophore which specifically affects trans Golgi cisternae. Gametangia treated with monensin did not complete cytoplasmic cleavage but, instead, released multinucleate gametes. Although swollen vacuoles were present, other gametogenic events including nuclear cap membrane formation occurred normally. Fractionation of subcellular components on sucrose density gradients demonstrated that Allomyces had both endoplasmic reticulum and Golgi equivalents with buoyant densities and marker enzyme profiles typical for these components in cells with stacked Golgi cisternae. For the first time, it was possible to demonstrate developmentally-regulated glycoproteins in vegetative hyphae and gametangia of Allomyces. Some of these glycoproteins appear in Golgi fractions, implying that the Golgi equivalents might be involved in glycosylation. In summary, Allomyces has a Golgi complex composed of individual or, perhaps, stacks of two Golgi equivalents. Although the endoplasmic reticulum was the source of the nuclear cap membrane, Golgi equivalents were the origin of cleavage furrow membranes formed during gametogenesis
- …