Behavior profiles in children with functional urinary incontinence before and after incontinence treatment

OBJECTIVE. The purpose of this work was to analyze prospectively the prevalence of behavioral disorders in children with urinary incontinence because of nonneuropathic bladder-sphincter dysfunction before and after treatment for incontinence. METHODS. A total of 202 children with nonneuropathic bladder-sphincter dysfunction were enrolled in the European Bladder Dysfunction Study, in branches for urge syndrome (branch 1) and dysfunctional voiding (branch 2); 188 filled out Achenbach's Child Behavior Checklist before treatment and 111 after treatment. Child Behavior Checklist scales for total behavior problems were used along with subscales for externalizing problems and internalizing problems. RESULTS. After European Bladder Dysfunction Study treatment, the total behavior problem score dropped from 19% to 11%, the same prevalence as in the normative population; in branch 1 the score dropped from 14% to 13%, and in branch 2 it dropped from 23% to 8%. The prevalence of externalizing problems dropped too, from 12% to 8%: in branch 1 it was unchanged at 10%, and in branch 2 it dropped from 14% to 7%. The decrease in prevalence of internalizing problems after treatment, from 16% to 14%, was not significant. CONCLUSION. More behavioral problems were found in dysfunctional voiding than in urge syndrome, but none of the abnormal scores related to the outcome of European Bladder Dysfunction Study treatment for incontinence. With such treatment, both the total behavior problem score and the score for externalizing problems returned to normal, but the score for internalizing problems did not change. The drops in prevalence are statistically significant only in dysfunctional voiding

NMR study of organic ligands at the AZO nanoparticle surface

Ligands provide physicochemical functionality to colloidal nanoparticles (NPs). Used during synthesis to control nucleation and growth, they end up as a monolayer covering the NP surface and stabilizing the NP colloidal suspension [1]. After synthesis, they can be exchanged by others to change the properties of the suspension or to improve certain characteristics [2]. In the last few years NMR techniques have been developed that can give a molecular view on the NPs from the ligands’ point of view, both in a qualitative and quantitative way. Using this ‘NMR toolbox’ different NPs and ligands have already been investigated [2-5]. In current research, two new types of NP materials are being investigated: Aluminium-Zinc-Oxide NPs (AZO-NPs) surrounded with oleic acid ligands, and Cupper-Indium-Gallium-Sulfide NPs (CIGS) surrounded by non-hydrogen containing tin-sulfide ligands. Preliminary results of these studies will be presented

Ontogeny and cross species comparison of pathways involved in drug absorption, distribution, metabolism and excretion in neonates (review) : KIDNEY

The kidneys play an important role in many processes, including urine formation, water conservation, acid-base equilibrium, and elimination of waste. The anatomic and functional development of the kidney has different maturation time points in humans versus animals, with critical differences between species in maturation before and after birth. Absorption, distribution, metabolism, and excretion (ADME) of drugs vary depending on age and maturation, which will lead to differences in toxicity and efficacy. When neonate/juvenile laboratory animal studies are designed, a thorough knowledge of the differences in kidney development between newborns/children and laboratory animals is essential. The human and laboratory animal data must be combined to obtain a more complete picture of the development in the kidneys around the neonatal period and the complexity of ADME in newborns and children. This review examines the ontogeny and cross-species differences in ADME processes in the developing kidney in preterm and term laboratory animals and children. It provides an overview of insights into ADME functionality in the kidney by identifying what is currently known and which gaps still exist. Currently important renal function properties such as glomerular filtration rate, renal blood flow, and ability to concentrate are generally well known, while detailed knowledge about transporter and metabolism maturation is growing but is still lacking. Preclinical data in those properties is limited to rodents and generally covers only the expression levels of transporter or enzyme-encoding genes. More knowledge on a functional level is needed to predict the kinetics and toxicity in neonate/juvenile toxicity and efficacy studies

INITIAL SCREENING FOR BEDWETTING: THE USE OF QUESTIONNAIRES AND VOIDING DIARIES First results from a National Belgian study

Title Initial screening for bedwetting: the use of questionnaires and voiding diaries. First results from a National Belgian study Authors S. Karamaria2, N. Ranguelov3, P. Hansen4, V. De Boe5, P. Verleyen6, J. Vande Walle1,2, L. Dossche2, A. Bael7,8 1Department of Pediatric Nephrology, UZ Gent, Ghent, 2Ghent University, 3Department of Pediatrics, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, 4Department of Pediatrics, CHU Tivoli, La Louvière, 5Department of Urology, UZ Brussel, Brussels, 6Department of Urology, AZ Groeninge, Kortrijk, 7Department of Pediatrics, Pediatric Nephrology, ZNA Koningin Paola Kinderziekenhuis, Antwerp; 8Faculty of Medicine, University of Antwerp, Antwerp Background International guidelines have a consensus that stratification of nocturnal enuresis (NE) into non-monosymptomatic (NMNE) and monosymptomatic (MNE) is mandatory at intake to optimize therapeutic approach. This stratification is based on clinical parameters (presence or absence of Lower Urinary Tract Symptoms (LUTS) respectively). To identify clinical parameters a checklist (Clinical Management Tool (CMT)) and/or voiding diaries based on home recordings can be used. However, these recordings can be time consuming and difficult for the family. Moreover, the added value to the CMT, especially in treatment naïve patients, is rather expert opinion than evidence based. Methods The aim of this study run in 7 Belgian Hospitals, was to document in treatment naïve NE patients >5 years: 1) The prevalence of MNE vs NMNE 2) the added value and correlation of CMT and/or diary in differentiating NE. Two study visits were scheduled: At visit 1 CMT was obtained, after a thorough medical history and basic assessments. If daytime incontinence and/or LUTS were identified, the diagnosis was NMNE. After the 1st study visit, a 2day voiding diary (fluid intake, voiding volumes, incontinence) was registered at home. During the second study visit, this diary was evaluated; if the micturition frequency was >8 or <3 and/or there was daytime incontinence, the diagnosis was NMNE. Results In total 109 children were included, of which19 were lost in follow up. Mean age was 7,7 (±2); 62 were boys (68,9%) and 27 were girls (30%). 68 (75, 6%) were included at a non-University center. Based on the CMT 13 children were diagnosed as MNE (16,7%) and 75 children as NMNE (83,3%). Based on the diary 16 children were diagnosed as MNE (17,8%) and 74 children as NMNE (82,2%). 25 children (27,8%) had the same diagnosis with both methods Regarding the presence or not of LUTS we observed significant inconsistencies between the CMT and the diary. Specifically there was fair agreement between the two modalities for urge (κ=0,219), moderate agreement for daytime incontinence (κ=0,432) and no agreement for abnormal voiding frequency (8 voidings/day) between what the parents answered on the CMT and what they registered in the diary (κ=-0,057). Conclusion NMNE is more frequent than MNE in treatment naïve patients. CMT alone versus CMT + diary had a different sensitivity and specificity of identifying LUTS : in absence of validation of the importance by a therapeutic trial outcome, we state that we can only consider patients as MNE when and CMT and diary do not demonstrate LUTS

Photocatalytic Performance of Undoped and Al-Doped ZnO Nanoparticles in the Degradation of Rhodamine B under UV-Visible Light:The Role of Defects and Morphology

Quasi-spherical undoped ZnO and Al-doped ZnO nanoparticles with different aluminum content, ranging from 0.5 to 5 at% of Al with respect to Zn, were synthesized. These nanoparticles were evaluated as photocatalysts in the photodegradation of the Rhodamine B (RhB) dye aqueous solution under UV-visible light irradiation. The undoped ZnO nanopowder annealed at 400 &deg;C resulted in the highest degradation efficiency of ca. 81% after 4 h under green light irradiation (525 nm), in the presence of 5 mg of catalyst. The samples were characterized using ICP-OES, PXRD, TEM, FT-IR, 27Al-MAS NMR, UV-Vis and steady-state PL. The effect of Al-doping on the phase structure, shape and particle size was also investigated. Additional information arose from the annealed nanomaterials under dynamic N2 at different temperatures (400 and 550 &deg;C). The position of aluminum in the ZnO lattice was identified by means of 27Al-MAS NMR. FT-IR gave further information about the type of tetrahedral sites occupied by aluminum. Photoluminescence showed that the insertion of dopant increases the oxygen vacancies reducing the peroxide-like species responsible for photocatalysis. The annealing temperature helps increase the number of red-emitting centers up to 400 &deg;C, while at 550 &deg;C, the photocatalytic performance drops due to the aggregation tendency

COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study

Background To date, few data on paediatric COVID-19 have been published, and most reports originate from China. This study aimed to capture key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic. Methods This multicentre cohort study involved 82 participating health-care institutions across 25 European countries, using a well established research network—the Paediatric Tuberculosis Network European Trials Group (ptbnet)—that mainly comprises paediatric infectious diseases specialists and paediatric pulmonologists. We included all individuals aged 18 years or younger with confirmed SARS-CoV-2 infection, detected at any anatomical site by RT-PCR, between April 1 and April 24, 2020, during the initial peak of the European COVID-19 pandemic. We explored factors associated with need for intensive care unit (ICU) admission and initiation of drug treatment for COVID-19 using univariable analysis, and applied multivariable logistic regression with backwards stepwise analysis to further explore those factors significantly associated with ICU admission. Findings 582 individuals with PCR-confirmed SARS-CoV-2 infection were included, with a median age of 5·0 years (IQR 0·5–12·0) and a sex ratio of 1·15 males per female. 145 (25%) had pre-existing medical conditions. 363 (62%) individuals were admitted to hospital. 48 (8%) individuals required ICU admission, 25 (4%) mechanical ventilation (median duration 7 days, IQR 2–11, range 1–34), 19 (3%) inotropic support, and one (<1%) extracorporeal membrane oxygenation. Significant risk factors for requiring ICU admission in multivariable analyses were being younger than 1 month (odds ratio 5·06, 95% CI 1·72–14·87; p=0·0035), male sex (2·12, 1·06–4·21; p=0·033), pre-existing medical conditions (3·27, 1·67–6·42; p=0·0015), and presence of lower respiratory tract infection signs or symptoms at presentation (10·46, 5·16–21·23; p<0·0001). The most frequently used drug with antiviral activity was hydroxychloroquine (40 [7%] patients), followed by remdesivir (17 [3%] patients), lopinavir–ritonavir (six [1%] patients), and oseltamivir (three [1%] patients). Immunomodulatory medication used included corticosteroids (22 [4%] patients), intravenous immunoglobulin (seven [1%] patients), tocilizumab (four [1%] patients), anakinra (three [1%] patients), and siltuximab (one [<1%] patient). Four children died (case-fatality rate 0·69%, 95% CI 0·20–1·82); at study end, the remaining 578 were alive and only 25 (4%) were still symptomatic or requiring respiratory support. Interpretation COVID-19 is generally a mild disease in children, including infants. However, a small proportion develop severe disease requiring ICU admission and prolonged ventilation, although fatal outcome is overall rare. The data also reflect the current uncertainties regarding specific treatment options, highlighting that additional data on antiviral and immunomodulatory drugs are urgently needed. Funding ptbnet is supported by Deutsche Gesellschaft für Internationale Zusammenarbeit