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Schuster S, Reece J, Florentzou A, Apos E. Treating enuresis in children with neurodevelopmental disorders using bell and pad alarm. J Pediatr Urol 2021; 17:645.e1-645.e8. [PMID: 34353751 DOI: 10.1016/j.jpurol.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/27/2021] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE There is a high prevalence of enuresis in children with neurodevelopmental disorders, yet research regarding treatment for this group has been neglected. The efficacy of treatment using bell and pad alarm therapy is not well reported especially in children with neurodevelopmental disorders. This study sought to compare the treatment efficacy of practitioner-assisted bell-and-pad enuresis alarm therapy for children with neurodevelopmental disorders and typically developing children. STUDY DESIGN This study utilized the data of Apos et al. (2018), a retrospective medical record audit collected from multiple clinical settings across Australia. A total of 2986 patient records (3659 treatment records) were included. The participants were children aged 5-16 years, who were diagnosed with enuresis. Children with a neurodevelopmental disorder (n = 158) had a clinical diagnosis present in the medical history of attention deficit disorder, autism spectrum disorder, or intellectual disability. Children who indicated any of the following comorbidities were excluded: cerebral palsy, brain injury, malformation of the renal tract, previous bladder or renal surgery, spinal cord malformation, spinal cord trauma or tumor, or a neurodegenerative disorder. Treatment success was defined as ≥ 14 dry nights. Relapse was defined as one symptom recurrence per month post-interruption of treatment, as defined by the International Children's Continence Society definitions. RESULTS The success rate for children with neurodevelopmental disorders was 62% and typically developing children was 78%. There was no significant difference between the number of treatments received or relapse rates by those children with a neurodevelopmental disorder and typically developing children. The summary figure shows the percentage of children in each group after their first treatment who were successful (success defined as dry for ≥ 14 days), who succeeded (dry for ≥ 14 days) but then relapsed and those who showed no success. The percentage of children with no NDD who were successfully dry after the first treatment was 78%. Children with ID had success after the first treatment of 59%, the lowest of all groups analyzed. CONCLUSION The type of alarm therapy reported in this study is effective for treating enuresis in children with neurodevelopmental disorders.
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Affiliation(s)
- Sharynn Schuster
- Discipline of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia.
| | - John Reece
- School of Psychological Sciences, Australian College of Applied Psychology, Melbourne, Victoria, Australia
| | - Andrew Florentzou
- Discipline of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Esther Apos
- Public Health and Preventative Medicine, Monash University, Victoria, Australia
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Abstract
INTRODUCTION As a subset of artificial intelligence, machine learning techniques (MLTs) may evaluate very large and raw datasets. In this study, the aim is to establish a model by MLT for the prediction of enuresis in children. MATERIALS AND METHODS The study included 8,071 elementary school students. A total of 704 children had enuresis. For analysis of data with MLT, another group including 704 nonenuretic children was structured with stratified sampling. Out of 34 independent variables, 14 with high feature values significantly affecting enuresis were selected. A model of estimation was created by training the data. RESULTS Fourteen independent variables in order of feature importance value were starting age of toilet training, having urinary urgency, holding maneuvers to prevent voiding, frequency of defecation, history of enuresis in mother and father, having child's own room, parent's education level, history of enuresis in siblings, consanguineous marriage, incomplete bladder emptying, frequent voiding, gender, history of urinary tract infection, and surgery in the past. The best MLT algorithm for the prediction of enuresis was determined as logistic regression algorithm. The total accuracy rate of the model in prediction was 81.3%. CONCLUSION MLT might provide a faster and easier evaluation process for studies on enuresis with a large dataset. The model in this study may suggest that selected variables with high feature values could be preferred with priority in any screening studies for enuresis. MLT may prevent clinical errors due to human cognitive biases and may help the physicians to be proactive in diagnosis and treatment of enuresis.
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Affiliation(s)
- Baran Tokar
- Department of Pediatric Surgery, School of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Mukaddes Baskaya
- Department of Pediatric Nursing, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Ozer Celik
- Department of Mathematics-Computer, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Fatih Cemrek
- Department of Statistics, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Ayfer Acikgoz
- Department of Pediatric Nursing, Eskisehir Osmangazi University, Eskisehir, Turkey
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Ghezzi E, Chan M, Kalisch Ellett LM, Ross TJ, Richardson K, Ho JN, Copley D, Steele C, Keage HAD. The effects of anticholinergic medications on cognition in children: a systematic review and meta-analysis. Sci Rep 2021; 11:219. [PMID: 33420226 PMCID: PMC7794471 DOI: 10.1038/s41598-020-80211-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/14/2020] [Indexed: 01/29/2023] Open
Abstract
Cognitive side effects of anticholinergic medications in older adults are well documented. Whether these poor cognitive outcomes are observed in children has not been systematically investigated. We aimed to conduct a systematic review and meta-analysis on the associations between anticholinergic medication use and cognitive performance in children. Systematic review was conducted using Medline, PsychInfo, and Embase, identifying studies testing cognitive performance relative to the presence versus absence of anticholinergic medication(s) in children. We assessed effects overall, as well as relative to drug class, potency (low and high), cognitive domain, and duration of administration. The systematic search identified 46 articles suitable for meta-analysis. For the most part, random effects meta-analyses did not identify statistically significant associations between anticholinergic exposure and cognitive performance in children; the one exception was a small effect of anticholinergic anti-depressants being associated with better cognitive function (Hedges' g = 0.24, 95% CI 0.06-0.42, p = 0.01). Anticholinergic medications do not appear to be associated with poor cognitive outcomes in children, as they do in older adults. The discrepancy in findings with older adults may be due to shorter durations of exposure in children, differences in study design (predominantly experimental studies in children rather than predominantly epidemiological in older adults), biological ageing (e.g. blood brain barrier integrity), along with less residual confounding due to minimal polypharmacy and comorbidity in children.
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Affiliation(s)
- Erica Ghezzi
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, 5000, Australia
| | - Michelle Chan
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, 5000, Australia
| | | | - Tyler J Ross
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, 5000, Australia
| | | | - Jun Ni Ho
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Dayna Copley
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, 5000, Australia
| | - Claire Steele
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, 5000, Australia
| | - Hannah A D Keage
- Justice and Society, University of South Australia, GPO BOX 2741, Adelaide, 5000, Australia.
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Kılıç A, Övünç Hacıhamdioğlu D, Tural E, Karademir F. Evaluation of neuropsychological development of children diagnosed with primary monosymptomatic nocturnal enuresis: A pilot study. Turk J Urol 2020; 46:tud.2020.19122. [PMID: 32449672 PMCID: PMC7360154 DOI: 10.5152/tud.2020.19122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 01/04/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Studies on primary monosymptomatic nocturnal enuresis have supported neuromotor development delay. This study aims to examine the neuropsychological development of children with primary monosymptomatic nocturnal enuresis. MATERIAL AND METHODS This study included 30 children diagnosed with primary monosymptomatic nocturnal enuresis and 30 healthy children. Both groups were analyzed by pediatric psychologists using the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Bender Gestalt Visual Motor Detection test. The WISC-R test is an intelligence test that includes six verbal subscales (information, similarities, arithmetic, vocabulary, judgment, and digit span) and six performance subscales (picture completion, picture arrangement, block design, object assembly, coding, and labyrinths). The Bender Gestalt test is a psychological assessment instrument used to evaluate visuomotor functioning, visuospatial functions, spatial memory, visuomotor integration skills, and visual perception skills. RESULTS There were no differences in age (7.66±0.9 versus 8±1.07 years, p>0.05) or sex (20 females versus 20 males, p>0.05) between the groups. Picture completion (p=0.024), picture arrangement (p=0.001), and object assembly test (p=0.000) performance was found to be worse in subjects with primary monosymptomatic nocturnal enuresis. Similarity (p=0.021) and judgment tests (p=0.048) of the verbal subtests were also found to be delayed in the nocturnal enuresis cases. CONCLUSION Our results suggest that children with nocturnal enuresis have lower performance compared with the control group in terms of abstract thinking, correct expression of thought, cause-result relation, short-term memory, and problem-solving ability. These children should be routinely tested by neurodevelopment tests and receive support in areas in which they are delayed.
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Affiliation(s)
- Ayben Kılıç
- Department of Pediatrics, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Duygu Övünç Hacıhamdioğlu
- Department of Pediatrics, Division of Pediatric Nephrology, Bahçeşehir University School of Medicine, Medical Park Göztepe Hospital, İstanbul, Turkey
| | - Ersin Tural
- Department of Pediatrics, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
| | - Ferhan Karademir
- Department of Pediatrics, Sultan Abdülhamid Han Training and Research Hospital, İstanbul, Turkey
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Abstract
Introduction: Non-neurogenic urinary incontinence in children is a common condition that affects the quality of life for both patients and parents. Symptoms may occur in the daytime, nighttime, or both and may be the result of structural and functional anomalies. Evaluation and management of associated co-morbidities, such as constipation is critical to management. Behavioral therapy is a fist line therapy in most cases of non-neurogenic urinary incontinence and pharmacologic therapy a second-line therapy.Areas covered: In this review, the authors cover the pharmacologic agents, FDA approved and commonly used non-FDA approved, available for the treatment of four non-structural etiologies of non-neurogenic urinary incontinence in children. These include nocturnal enuresis, overactive bladder, giggle incontinence, and dysfunctional voiding.Expert opinion: Non-neurogenic causes of urinary incontinence in children represent a complicated medical condition that requires both pharmacologic and non-pharmacologic management. Limited FDA-approved therapies as well as suboptimal results with approved therapies due to a lack in the understanding of the underlying pathophysiology and patient selection may lead to the use of alternative non-FDA approved therapies.
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Affiliation(s)
- Tiernan Middleton
- Class of 2020, University of Central Florida College of Medicine, Orlando, FL, USA
| | - Pamela Ellsworth
- Pediatric Urology, Nemours Children's Hospital, Orlando, FL, USA.,Urology, Central Florida College of Medicine, Orlando, FL, USA
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Trajanovska M, King S, Goldfeld S, Gibb S. A novel method of rapid appraisal of clinical practice guidelines for children with enuresis. J Pediatr Urol 2019; 15:333.e1-333.e9. [PMID: 31217085 DOI: 10.1016/j.jpurol.2019.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 05/16/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Enuresis (bedwetting) is a common but variably managed pediatric condition. Despite an abundance of published documents which provide recommendations for clinical evaluation and management of enuresis, no formal appraisal of their methodological quality has been undertaken. OBJECTIVE The objective of the study is to evaluate the quality of current pediatric guidelines for enuresis (bedwetting) using a novel method of appraisal. STUDY DESIGN A comprehensive gray literature search was undertaken to identify guideline documents that provided recommendations for management of enuresis in children and adolescents. The search strategy included guideline databases, targeted websites, Google search engines, and MEDLINE. Guideline documents included clinical practice guidelines, consensus documents, position statements, and other clinical review documents. Each document underwent basic appraisal by two independent assessors using the International Centre for Allied Health Evidence (iCAHE) Guideline Quality Checklist. Those documents which (1) had an iCAHE quality score of ≥10; (2) used a systematic search strategy; and (3) linked evidence to their recommendations underwent further detailed appraisal using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. RESULTS Eighteen documents were shortlisted for basic appraisal. The iCAHE highlighted a lack of information regarding underlying evidence and dates (mean score 36% and 41%, respectively). Only three documents met basic quality criteria and progressed to detailed appraisal using the AGREE II. These included guidelines produced by the Paediatric Society of New Zealand and National Clinical Guideline Centre and a position statement from the Canadian Paediatric Society. All three guidelines presented clear and unambiguous recommendations (mean score 80%). However, information regarding stakeholder involvement was lacking (mean score 50%). CONCLUSIONS Several guidelines exist for the evaluation and management of children with enuresis, but many lack appropriate methodological quality standards. The guideline produced by the National Clinical Guideline Centre achieved the highest quality rating and is recommended for future adaptation and implementation in relevant clinical settings.
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Affiliation(s)
- M Trajanovska
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia 3052
| | - S King
- Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Victoria, 3052, Australia; Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, 3052, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, 3052, Australia
| | - S Goldfeld
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Victoria, Australia 3052; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, 3052, Australia; Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, 3052, Australia
| | - S Gibb
- Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, 3052, Australia; Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, 3052, Australia.
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Apos E, Schuster S, Reece J, Whitaker S, Murphy K, Golder J, Leiper B, Sullivan L, Gibb S. Enuresis Management in Children: Retrospective Clinical Audit of 2861 Cases Treated with Practitioner-Assisted Bell-and-Pad Alarm. J Pediatr 2018; 193:211-216. [PMID: 29246468 DOI: 10.1016/j.jpeds.2017.09.086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/03/2017] [Accepted: 09/29/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To establish the treatment efficacy of practitioner-assisted bell-and-pad alarm therapy in children with enuresis between the ages of 5 and 16 years by retrospective medical chart review of 2861 children in multiple clinical settings. STUDY DESIGN This review was conducted across 7 Australian clinical practices. The primary outcome measure was the time taken for children with either primary, secondary, monosymptomatic, or nonmonosymptomatic enuresis to be dry for 14 consecutive nights. The secondary outcome measure was to determine relapse rates, defined as 1 symptom recurrence per month post interruption of treatment. Data were analyzed by correlation and χ2 test via IBM SPSS Statistics (version 22). RESULTS The overall success rate of the bell and pad treatment was 76%, irrespective of age. The mean treatment time to achieve dryness was 62.1 ± 30.8 days, and the relapse rate was 23%. Concurrent bowel dysfunction was associated with a slightly lower success rate (74%). Concurrent lower urinary tract symptoms were associated with a lower success rate (73%) and greater relapse (1.75 times more likely to relapse). Children with secondary enuresis had significantly greater success than those with primary enuresis (82% vs 74%). CONCLUSION The type of alarm therapy reported in this study is highly effective. This study will provide the basis for clinical guidelines and practice tools for clinicians, which will help to reduce variation in care pathways for alarm treatment for enuresis.
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Affiliation(s)
- Esther Apos
- Division of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia.
| | - Sharynn Schuster
- Division of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - John Reece
- School of Psychological Sciences, Australian College of Applied Psychology, Melbourne, Victoria, Australia
| | - Shirley Whitaker
- Department of Clinical Services, Grampians Regional Continence Service, Ballarat, Victoria, Australia
| | - Kerry Murphy
- Enuresis and Continence Service, Princess Margaret Hospital, Perth, Western Australia, Australia
| | - John Golder
- Redlands Clinic, Cleveland, Queensland, Australia
| | - Beverley Leiper
- Children's Continence Clinic, Craigieburn Health Service, Northern Health, Melbourne, Australia
| | | | - Susie Gibb
- Department of General Medicine and Outpatient Services, Royal Children's Hospital, Melbourne, Victoria, Australia
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Saarikoski A, Koppeli R, Salanterä S, Taskinen S, Axelin A. Voiding school as a treatment of daytime incontinence or enuresis: Children's experiences of the intervention. J Pediatr Urol 2018; 14:56.e1-56.e7. [PMID: 29037865 DOI: 10.1016/j.jpurol.2017.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 09/10/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Daytime incontinence and enuresis are common problems in otherwise healthy children, and negatively influence their social lives and self-esteem. Motivation for treatment is often a real clinical problem. Children's experiences of their incontinence treatments have not been previously described. OBJECTIVE The aim of this study was to describe children's experiences of the Voiding School intervention as a treatment for their incontinence. STUDY DESIGN A qualitative, descriptive focus-group study with a purposive sample was conducted at a Finish university hospital in 2014. Children aged 6-12 years participated in the Voiding School at an outpatient clinic. The intervention included two 1-day group visits 2 months apart. The educational content was based on the International Children Continence Society's standards for urotherapy. The education was delivered with child-oriented teaching methods. At the end of the second visit, 19 children were interviewed in five groups. Data were analysed with inductive content analysis. RESULTS The children described incontinence as an embarrassing problem, which they had to hide at any cost. They had experienced bullying and social isolation because of it. Normal outpatient visits emphasized adult-to-adult communication, which made the children feel like outsiders. The children perceived the Voiding School as a nice and child-oriented experience. Making new friends was especially important to younger boys who felt that the Voiding School day was too long and issue-oriented. In the Voiding School, videos and 'learning by doing' helped the children to understand the basis of given advice, and they were able to learn new habits, which gave them control over the incontinence; this helped them to become 'the boss of the bladder'. Sharing experiences and improvements in their incontinence with their peers supported the children's self-esteem and encouraged them to do new things, such as staying overnight with friends. These experiences helped them to acquire control over the problem (Summary Figure). DISCUSSION According to the children's experiences, normal outpatient visits were only appointments for adults, and not very useful for children. In the Voiding School, they were respected as being the main person, and their views were listened to. The results underlined the importance of a child-oriented approach to patient education with regard to children, and provided encouragement to further develop the intervention. CONCLUSION Child orientation, peer support, learning by doing, and understanding the cause and effect helped children to gain control over their bladders. Based on the children's experiences, this could be achieved by a voiding school.
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Affiliation(s)
- A Saarikoski
- Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland; Department of Nursing Science, University of Turku, Turku, Finland.
| | - R Koppeli
- Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - S Salanterä
- Department of Nursing Science, University of Turku, Turku, Finland
| | - S Taskinen
- Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - A Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
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Abstract
BACKGROUND Enuresis results in behavioural disorder in children. This study investigated the behavioural disorders in children possessing primary enuresis. MATERIALS AND METHODS In this cross-sectional study, 100 children with primary enuresis were referred to children's hospital Khorramabad; the census method was used in this study. Data were collected using a short screening instrument for enuresis psychological problems, the reliability and validity of which have been confirmed in previous studies. First, a questionnaire was used to assess academic failure, anxiety, behavioural disorders, sleep, and psychological disorders. Results obtained were compared in terms of gender and age. Statistical analyses using inferential and descriptive statistics including Chi-square and Fisher test were employed. RESULTS The average age of children was 8.46 years. Sixty-six per cent of participants were male and the rest of them were female. Ninety per cent of subjects were between the age range of 1-9 years, and 10% were over 10 years old. Forty-three per cent of children suffered from anxiety disorders and 34% had sleep disorders, 4% also suffered from academic failure. Among behavioural disorders, hyperactivity and restlessness were the most common disorders, and they were significantly higher in nine boys. Headache, obsessive, and sleep disorders were more common in children above 10. There was a significant correlation between eating disorders, headache, sleep disorders, and strange movements in males, while feelings of sadness were more common in females. CONCLUSION Social personality development in children with enuresis can be improved by informing parents of enuresis.
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Affiliation(s)
- Azam Mohsenzadeh
- a Department of Pediatrics, Faculty of Medicine , Lorestan University of Medical Sciences , Khorramabad , Iran
| | - Shokoufeh Ahmadipour
- a Department of Pediatrics, Faculty of Medicine , Lorestan University of Medical Sciences , Khorramabad , Iran
| | - Ali Farhadi
- b Department of Psychology, Faculty of Medicine , Lorestan University of Medical Sciences , Khorramabad , Iran
| | - Korosh Shahkarami
- c Department of Psychology, Faculty of Medicine , Lorestan University of Medical Sciences , Khorramabad , Iran
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Abstract
INTRODUCTION Overactive bladder (OAB) symptoms are complex and generally require long-term therapy. Nevertheless, it has been demonstrated that persistence rates of antimuscarinic drug use are low in adults. Better understanding of the treatment patterns of children treated with antimuscarinics could help to improve drug management. Our objective was to evaluate persistence rates of patients under 20 years of age on antimuscarinic therapy over a four-year period. METHODS Patients having received a first-ever antimuscarinic drug prescription between April 2007 and March 2008 were identified using IMS Brogan's Public and Private Drug Plans database. Canadian drug claims data from Private Drug Plans, Régie de l'Assurance Maladie du Québec, and Ontario Public Drug Plans were analyzed retrospectively. Patients were followed for four years to assess the prescribed drugs, the lines of treatment, and the duration of each treatment. RESULTS Data were available for 374 patients. The most prescribed drug as a first-line therapy was oxybutynin (87.2%), followed by tolterodine LA (5.9%). Patients refilled their index prescriptions for an average of 429 days. Solifenacin had the highest mean duration of index therapy (765 days). The median number of antimuscarinics prescribed was one. At the end of the followup, 44 patients were still on therapy. Reasons for discontinuation of treatment were not available. CONCLUSIONS Overall discontinuation rate of antimuscarinic therapy in children is comparable to what has been reported in adult patients with OAB. However, children seem to persist on the medication for a longer duration before adherence rates start declining. The low rate of persistence highlights the need to identify the reasons for discontinuation of therapy in children in order to obtain better persistence rates.
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Čorejová A, Jánošiková D, Pospíšilová V, Rauová D, Kyselovič J, Hrabovská A. Cessation of Nocturnal Enuresis after Intervention with Methylcobalamin in an 18-Year-Old Patient with Autism. J Child Adolesc Psychopharmacol 2015; 25:821-3. [PMID: 25325786 DOI: 10.1089/cap.2014.0023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Adela Čorejová
- 1 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University , Bratislava, Slovak Republic
| | - Daniela Jánošiková
- 2 Department of Psychology, Faculty of Philosophy and Arts, Trnava University , Slovak Republic
| | | | - Drahomíra Rauová
- 4 Department of Pharmaceutical Analysis and Nuclear Pharmacy, Faculty of Pharmacy of Comenius University , Bratislava, Slovak Republic.,5 Toxicological and Antidoping Centre, Comenius University , Bratislava, Slovak Republic
| | - Jan Kyselovič
- 1 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University , Bratislava, Slovak Republic
| | - Anna Hrabovská
- 1 Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University , Bratislava, Slovak Republic.,5 Toxicological and Antidoping Centre, Comenius University , Bratislava, Slovak Republic.,6 Biomedical Research Center, University Hospital , Hradec Králové, Czech Republic
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Yousefichaijan P, Sharafkhah M, Cyrus A, Rafeie M. Therapeutic Efficacy of Hydrochlorothiazide in Primary Monosymptomatic Nocturnal Enuresis in Boys With Idiopathic Hypercalciuria. Nephrourol Mon 2015; 7:e29127. [PMID: 26543832 PMCID: PMC4630497 DOI: 10.5812/numonthly.29127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/11/2015] [Accepted: 07/25/2015] [Indexed: 11/16/2022] Open
Abstract
Background: Idiopathic hypercalciuria (IHC) can be one of the causes of nocturnal enuresis (NE) and hydrochlorothiazide (HCT) ameliorates hypercalciuria. Objectives: The aim of this study was to assess the therapeutic efficacy of HCT in boys with primary monosymptomatic NE (PMNE). Patients and Methods: This study was a randomized double-blind placebo-controlled clinical trial. A hundred boys with PMNE and IHC were randomly assigned into two groups of experimental (treated with HCT 1 mg/kg/day) and control and all patients were followed for 4 months for the number of wet-night episodes. Results: The mean numbers of wet-night episodes in the first (intervention: 8.34 ± 8.54, control: 9.1 ± 9.3, P = 0.3), second (7.1 ± 7.3, 7.9 ± 8.1, P = 0.4), third (7.8 ± 8, 7.9 ± 8.1, P = 0.1) and fourth (4.9 ± 5.1, 5.9 ± 6, P = 0.3) months were not significantly different between the two groups. However, the decrease in the average wet-night episodes during the 4 months of treatment in the intervention group (P = 0.019) unlike the control group. Not more significant compared to control group (P = 0.191). All patients who were treated by HCT became normocalciuric. However, in 21 patients the dose was increased to 2 mg/kg/day. Conclusions: Single daily dose of HCT is a safe and effective therapeutic option in the treatment of PMNE in children with IHC.
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Affiliation(s)
- Parsa Yousefichaijan
- Department of Pediatrics, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
| | - Mojtaba Sharafkhah
- Department of Students Research Committee, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
- Corresponding author: Mojtaba Sharafkhah, Students Research Committee, School of Medicine, Arak University of Medical Sciences, P. O. Box: 3819693345, Arak, IR Iran. Tel: +98-9119180298, Fax: +98-8633133193, E-mail:
| | - Ali Cyrus
- Department of Surgery, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
| | - Mohawmmad Rafeie
- Department of Biostatistics and Epidemiology, School of Medicine, Arak University of Medical Sciences, Arak, IR Iran
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Mohammed AH, Saleh AG, Al Zoheiry I. Frequency of bedwetting among primary school children in Benha city, Egypt. Egyptian Journal of Medical Human Genetics 2014. [DOI: 10.1016/j.ejmhg.2014.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Kumar P. Editorial Comment to Spina bifida occulta: Not to be overlooked in children with nocturnal enuresis. Int J Urol 2013; 20:836. [DOI: 10.1111/iju.12097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Praveen Kumar
- Department of Pediatrics; Kalawati Saran Childrens' Hospital; Lady Hardinge Medical College; New Delhi; India
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Esposito M, Gallai B, Parisi L, Roccella M, Marotta R, Lavano SM, Mazzotta G, Patriciello G, Precenzano F, Carotenuto M. Visuomotor competencies and primary monosymptomatic nocturnal enuresis in prepubertal aged children. Neuropsychiatr Dis Treat 2013; 9:921-6. [PMID: 23847418 PMCID: PMC3700782 DOI: 10.2147/ndt.s46772] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Primary monosymptomatic nocturnal enuresis (PMNE) is a common problem in the developmental ages; it is the involuntary loss of urine during the night in children older than 5 years of age. Several clinical observations have suggested an association between bedwetting and developmental delays in motricity, language development, learning disability, physical growth, and skeletal maturation. The aim of the present study is to evaluate the prevalence of fine motor coordination and visuomotor integration abnormalities in prepubertal children with PMNE. METHODS The study population included 31 children (16 males, 15 females; mean age 8.14 years ± 1.36 years), and the control group comprised 61 typical developing children (32 males, 29 females; mean age 8.03 years ± 1.44 years). The whole population underwent a clinical evaluation to assess total intelligence quotient level, visuomotor integration (VMI) skills, and motor coordination performance (using the Movement Assessment Battery for Children, or M-ABC). RESULTS No significant differences between the two study groups were found for age (P = 0.725), gender (P = 0.886), z-body mass index (P = 0.149), or intellectual abilities (total intelligence quotient) (P = 0.163). The PMNE group showed a higher prevalence of borderline performance on M-ABC evaluation and in pathologic performance on VMI Total Task compared to controls (P < 0.001). No significant differences between the two study groups were found for pathologic performances on the M-ABC (P = 0.07), VMI Visual Task (P = 0.793), and VMI Motor Task (P = 0.213). CONCLUSION Our findings pinpointed that PMNE should not be considered as a voiding disorder alone and, consequently, the children affected should be referred to specific rehabilitative programs that aim to improve motor coordination and visuomotor integration.
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Affiliation(s)
- Maria Esposito
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy
| | - Beatrice Gallai
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Italy
| | - Rosa Marotta
- Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
| | | | - Giovanni Mazzotta
- Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy
| | - Giuseppina Patriciello
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy
| | - Francesco Precenzano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy
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Esposito M, Gallai B, Parisi L, Roccella M, Marotta R, Lavano SM, Mazzotta G, Carotenuto M. Primary nocturnal enuresis as a risk factor for sleep disorders: an observational questionnaire-based multicenter study. Neuropsychiatr Dis Treat 2013; 9:437-43. [PMID: 23579788 PMCID: PMC3621720 DOI: 10.2147/ndt.s43673] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Primary nocturnal enuresis (PNE) is a common problem in developmental age with an estimated overall prevalence ranging from 1.6% to 15%, and possible persistence during adolescence. There is a growing interest in the sleep habits of children affected by PNE, which is derived from the contradictory data present in clinical literature. The aim of the present study was to evaluate the presence of sleep disturbances in a population of children affected by PNE, and to identify whether PNE could be considered as a risk factor for sleep disturbances among children. MATERIALS AND METHODS A total of 190 PNE children (97 males, 93 females) aged 7-15 years, (mean 9.64 ± 1.35 years), and 766 typically developing children matched for age (P = 0.131) and gender (P = 0.963) were enrolled. To evaluate the presence of sleep habits and disturbances, all of the subjects' mothers filled out the Sleep Disturbances Scale for Children (SDSC), a questionnaire consisting of six subscales: Disorders in Initiating and Maintaining Sleep (DIMS), Sleep Breathing Disorders (SBD), Disorders of Arousal (DA), Sleep-Wake Transition Disorders (SWTD), Disorders of Excessive Somnolence (DOES), and Nocturnal Hyperhidrosis (SHY). The results were divided into "pathological" and "normal" scores using a cut-off value (pathological score = at least three episodes per week), according to the validation criteria of the test. Then, the Chi-square test was used to calculate the statistical difference and a univariate logistic regression analysis was applied to determine the role of PNE as a risk factor for the development of each category of sleep disorders and to calculate the odds ratio (OR). RESULTS PNE children show a higher prevalence of all sleep disturbances (41.03% DIMS; 85.12% SBD; 63.29% DA; 67.53% SWTD; 31.28% DOES; 37.92% SHY; 25.33% SDSC total score), and according to OR results (SDSC total score OR = 8.293, 95% confidence interval [CI] = 5.079-13.540; DIMS OR = 7.639, 95% CI = 5.192-11.238; SBD OR = 35.633, 95% CI = 22.717-55.893; DA OR = 13.734, 95% CI = 9.476-19.906; SWTD OR = 14.238, 95% CI = 9.829-20.625; DOES OR = 5.602, 95% CI = 3.721-8.432; SHY OR = 6.808, 95% CI = 4.608-10.059), PNE could be considered as a risk factor for the development of sleep disorders. CONCLUSION Among PNE children, sleep could be strongly altered, thus helping to affirm the hypothesis that PNE tends to alter sleep architecture, or it could itself be the consequence of an abnormal sleep structure. The findings also point to the existence of a potential increase in the risk of developing sleep disorders in the presence of PNE.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Beatrice Gallai
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy
| | - Rosa Marotta
- Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
| | | | - Giovanni Mazzotta
- Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy
| | - Marco Carotenuto
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
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Use pharmacological options sparingly and cautiously in children with nocturnal enuresis. Drugs Ther Perspect 2012; 28:12-14. [DOI: 10.1007/bf03262142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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&NA;. Use pharmacological options sparingly and cautiously in children with nocturnal enuresis. Drugs & Therapy Perspectives 2012. [DOI: 10.2165/11209770-000000000-00000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Sakellaropoulou AV, Hatzistilianou MN, Emporiadou MN, Aivazis VT, Goudakos J, Markou K, Athanasiadou-Piperopoulou F. Association between primary nocturnal enuresis and habitual snoring in children with obstructive sleep apnoea-hypopnoea syndrome. Arch Med Sci 2012; 8:521-7. [PMID: 22852010 PMCID: PMC3400898 DOI: 10.5114/aoms.2012.28809] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 11/03/2011] [Accepted: 12/27/2011] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Nocturnal enuresis (NE) and obstructive sleep apnoea-hypopnoea syndrome (OSAHS) are common problems during childhood, and population studies have reported a significant correlation between them. This study aimed to assess whether habitual snoring, mouth breathing and daytime sleepiness are associated with increased incidence of NE in children with OSAHS. MATERIAL AND METHODS Polysomnography was performed in 42 children (66.7% males), 3.5-14.5 years old, who were evaluated for sleep-disordered breathing (SDB). RESULTS Fourteen out of 42 children (33.3%) presented mild, 16 out of 42 (38.1%) moderate and 12 out of 42 (28.6%) severe degree of OSAHS. Apnea hypopnea index (AHI) ranged between 1.30-94.20 (10.54 ±15.67) events per hour of sleep. Nocturnal enuresis was reported in 7/42 (16.7%) of them. The main observed symptoms were snoring (90.5%), restless sleep (81%), mouth breathing (71.4%), nasal congestion (76.2%), and difficulty in arousal (52.4%). A statistically significant association was found between NE and mouth breathing (p = 0.014) or nasal congestion (p = 0.005). Children with OSAHS and NE had a higher arousal index (8.14 ±8.05) compared with OSAHS children without NE (4.61 ±7.95) (p = 0.19, z = -1.28). Snorers had higher levels of AHI (11.02 ±16.37) compared with non-snorers (6.05 ±4.81) (p = 0.33, z = -0.96), and habitually snorers (23/42, 54.76%) were at greater risk of having NE (4/23) than were non-snorers (0/4, p = 0.36). However, the prevalence of enuresis was not related to the severity of OSAHS, expressed as AHI (p = 0.70). CONCLUSIONS Mouth breathing, nasal congestion and high threshold of arousal during sleep should be more carefully evaluated in cases of children with NE who do not respond to standard treatment and present SDB.
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Gor RA, Fuhrer J, Schober JM. A retrospective observational study of enuresis, daytime voiding symptoms, and response to medical therapy in children with attention deficit hyperactivity disorder and autism spectrum disorder. J Pediatr Urol 2012; 8:314-7. [PMID: 21131234 DOI: 10.1016/j.jpurol.2010.10.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Accepted: 10/20/2010] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Children with attention deficit hyperactivity disorder (ADHD) show an increased prevalence of enuresis and other daytime voiding symptoms (DVS). There is also some evidence toward an increased prevalence of enuresis among children with autism spectrum disorder (ASD), but with no data available with respect to DVS or response to medical treatment. The aim of this study was to assess enuresis and DVS, along with treatment outcomes, in children with ASD, to aid urological management. METHODS A retrospective observational study on the incidence of enuresis and other DVS in 671 children with/without ADHD/ASD was performed. Symptomatic improvement ≥50% was required to be considered positive. Complete resolution of symptoms for 3 months after cessation of treatment was considered cure. RESULTS Symptomatic improvement with desmopressin or anticholinergic treatment was seen in 76% of patients without ADHD/ASD, 85% of patients with ADHD, and 100% of patients with ASD. Cure was seen in 61% of patients without ADHD/ASD, 48% of patients with ADHD, and 50% patients with ASD. Mean time to cure was 9 months in those without ADHD/ASD (N = 319), 10 months in those with ADHD (N = 62), and 8 months in those with ASD (N = 10) (P = 0.69). CONCLUSION Despite the small sample size of patients with ASD, our data show a favorable trend toward efficacy of desmopressin and anticholinergic therapy in these children with enuresis and DVS.
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Affiliation(s)
- Ronak A Gor
- Lake Erie College of Osteopathic Medicine, Erie, PA, USA
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Abstract
Nocturnal enuresis, or bedwetting, is the most common cause of urinary incontinence in children. It is known to have a significant psychosocial impact on the child as well as the family. Nocturnal enuresis typically presents as failure to become dry at night after successful daytime toilet training. It can be primary or secondary (developing after being successfully dry at night for at least 6 months). Children with nocturnal enuresis may have excessive nocturnal urine production, poor sleep arousal and/or reduced bladder capacity. Alarm therapy is the recommended first-line therapy, with treatment choices being influenced by the presence or absence of the abnormalities mentioned above. Children with nocturnal enuresis may also have daytime urinary urgency, frequency or incontinence of urine. This group (non-monosymptomatic nocturnal enuresis) requires a different clinical approach, with a focus on treating daytime bladder symptoms, which commonly involves pharmacotherapy with anticholinergic medications and urotherapy (including addressing bowel problems). This review discusses the current management of nocturnal enuresis using the terminologies recommended by the International Children's Continence Society.
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Affiliation(s)
- Aniruddh V Deshpande
- Department of Urology, The Childrens Hospital at Westmead, Westmead, NSW, Australia
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Abstract
BACKGROUND Co-occurrence of oral language disorders and enuresis in children. AIM To identify and analyze the relationship between instances of oral language disorders and enuresis in children. METHOD Clinical, quantitative and qualitative study, with a descriptive/interpretative outline, presented through two distinct situations. "Situation 1" refers to a group of 120 children between 3:0 and 10:0 years old, independently of gender and age, from a philanthropic Institution in Greater São Paulo. "Situation 2" refers specifically to the evaluation of children who have oral language disorders and enuresis. RESULTS Results indicated that enuretic children present a higher percentage of oral language disorders when compared to non-enuretic children, especially phonological disorders and talking very little. These results support the studies on co-occurrence of enuresis and oral language disorders, presented in papers that attribute a bio-psychic etiology to this co-morbidity. CONCLUSION Results indicated a relationship between enuresis and oral language disorders. Considering the interactions among language, body and psyche, it is suggested that speech therapists, when dealing with oral language disorders in children, also investigate the acquisition of their bladder sphincter control, in a bio-psychical approach.
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Abstract
OBJECTIVE To assess whether the components of the Healthy Kids Check (HKC), a preschool screening check recently added to the Australian Government's Enhanced Primary Care Program, are supported by evidence-based guidelines or reviews. DATA SOURCES Guideline and MEDLINE databases were searched for guidelines and systematic reviews published between 2000 and 2008 that were relevant to screening, prevention or well-child care in primary health care, and including children of preschool age. Search subjects reflected the HKC components: growth, weight, obesity, vision, hearing, oral health, enuresis, encopresis, allergic disease and food allergies. STUDY SELECTION 34 relevant guidelines or reviews were retrieved. DATA EXTRACTION For each component of the HKC, guidelines addressing the presumed rationale for screening, or the test or tool required to implement it, were reviewed. Relevant evidence-based and consensus-based guideline recommendations were assessed as either supporting or opposing components of the HKC, or stating that the evidence was insufficient to recommend screening of preschool children. DATA SYNTHESIS Guidelines were often inconsistent in their recommendations. Most of the components of the HKC (eg, screening for chronic otitis media and questioning about toilet habits) are not supported by evidence-based guidelines relevant to the primary care setting, though a number of consensus-based guidelines are supportive. CONCLUSIONS There is currently a dearth of evidence relevant to child health surveillance in primary care. The components of the HKC could be refined to better reflect evidence-based guidelines that target health monitoring of preschool children.
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Affiliation(s)
- Karyn E Alexander
- Department of General Practice, Monash University, Melbourne, VIC, Australia.
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Mohn J, Bakke A, Rokne B. Voiding disorders among children and adolescents: surveillance after ‘voiding school’ treatment. International Journal of Urological Nursing 2010. [DOI: 10.1111/j.1749-771x.2010.01085.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
AIM To determine the occurrence of primary nocturnal enuresis in 5-year-old outpatients in Slovenia and the possible correlations with different factors. METHODS The epidemiological study was conducted in Slovenia between 2005 and 2007. A special questionnaire was distributed randomly among the parents of 1846 5-year olds in children's outpatient clinics in all regions of Slovenia. RESULTS The response rate was on average 71.0%, which means that 7% of all Slovenian 5-year olds were included in the study. The occurrence of primary nocturnal enuresis was 8.7% and was higher in families with many siblings (chi(2) test, p < 0.01). The boy:girl ratio was 1.4 (Student t-test, p = 0.024). Parents were found to be more disturbed by the problem than their children (chi(2) test, p < 0.01). The maternal and paternal education levels of children with primary nocturnal enuresis did not differ from the Slovenian adult population (chi(2) test, p > 0,05). CONCLUSION The occurrence of primary nocturnal enuresis in 5-year-old outpatients in Slovenia is comparable with data from other countries. Primary nocturnal enuresis is more frequent in boys than in girls, with higher occurrence in families with more siblings, and parents are more disturbed by the problem than their children.
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Affiliation(s)
- N Semolic
- Division of Paediatrics, Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
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Tekin D, Suskan E, Pekpak E. Re: Resolution of diurnal incontinence and nocturnal enuresis after adenotonsillectomy in children. F. Firoozi, R. Batniji, A. R. Aslan, P. A. Longhurst and B. A. Kogan. J Urol 2006; 175: 1885-1888. J Urol 2008; 180:1186-7. [PMID: 18667213 DOI: 10.1016/j.juro.2008.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Indexed: 11/17/2022]
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Abstract
A case of secondary diurnal enuresis (SDE) after a car accident was treated with hypnosis by means of the Hypnotic Trauma Narrative, an instrument created by the authors for use with children who have been exposed to traumatic events and develop either classic symptoms of posttraumatic stress disorder or manifest other psychosomatic symptoms. An ABAB time-series design with multiple replications was employed to measure the relationship of the hypnotic treatment to the dependent measure: episodes of diurnal incontinence. The findings indicated a statistically significant relationship between the degree of change from phase to phase and the treatment. Hypnosis with the Hypnotic Trauma Narrative was deemed efficacious as a method for the treatment of secondary diurnal enuresis. The patient was symptom-free at follow-up 6 months later.
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Affiliation(s)
- Alex Iglesias
- Private Practice, Palm Beach Gardens, Florida 33410, USA.
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Caldwell PHY, Edgar D, Hodson E, Craig JC. Bedwetting and toileting problems in children. Med J Aust 2005. [DOI: 10.5694/j.1326-5377.2005.tb06827.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Elisabeth Hodson
- NHMRC Centre of Clinical Research Excellence in Renal Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW 2145
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Wicks GR. Bedwetting and toileting problems in children. Med J Aust 2005; 182:596; author reply 596. [PMID: 15938694 DOI: 10.5694/j.1326-5377.2005.tb06826.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Accepted: 03/31/2005] [Indexed: 11/17/2022]
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