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Transappendicular Continent Cystostomy Technique (Mitrofanoff Principle)
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
A short tunnel usually causes stomal incontinence. Evaluation should be done thoroughly to exclude other causes, such as high reservoir pressure. Using a bulking agent can be tried with some success in the short term,20 but long-term data are lacking. The reported agent used is dextranomer/hyaluronic acid.20–23 If failed, surgical revision can be undertaken by either complete take-down and use of ileal segment, or alternatively leaving the existing channel and wrapping an additional detrusor muscle over the channel.24
Urinary tract infections
Published in Prem Puri, Newborn Surgery, 2017
Since its approval by the Federal Drug Administration, dextranomer/hyaluronic acid (Dx/HA) copolymer has revolutionized the management of VUR. Its applicability to newborns has not been well documented. However, given the low morbidity associated with this procedure, injection therapy is a viable option in the face of recurrent UTIs and low-grade VUR. It should be noted, however, that injection into a newborn bladder can be challenging, and long-term follow-up studies after injection in younger children are lacking.
Fecal incontinence
Published in Miranda A. Farage, Howard I. Maibach, The Vulva, 2017
Kevin Kniery, Vanessa P. Ho, Scott R. Steele
The overall success of injectables is modest at best with improvement seen early on, though with diminished results over time. One of the few randomized controlled trials did show a significant improvement when using silicone as compared to carbon-coated microbeads (23). A 2013 Cochrane review found only one large, properly performed trial, from which the results supported dextranomer in hyaluronic acid gel that demonstrated 50% of patients had significant improvements in the short term, with no studies having significant long-term data (24).
Biofilm-based delivery approaches and specific enrichment strategies of probiotics in the human gut
Published in Gut Microbes, 2022
Jie Gao, Faizan Ahmed Sadiq, Yixin Zheng, Jinrong Zhao, Guoqing He, Yaxin Sang
Necrotizing enterocolitis (NEC) is an inflammatory necrosis of the gut of premature infants which leads to the appearance of bloated and sensitive abdomen and results in feeding intolerance, and bloody diarrhoea and thus it results in a significant surgical emergency in neonates. A large number of meta-analyses have evaluated the effect of probiotics (e.g., Bifidobacterium and Lactobacillus) in NEC, concluding that probiotic intervention decreases the risk of NEC and reduces mortality in premature infants.90,91 A recent study using planktonic and biofilm forms of L. reuteri, on maltose loaded dextranomer microspheres (DM), to treat NEC in a rat model reported no significant effect of the planktonic doses of L. reuteri on NEC, compared to its biofilm formulation which reduced NEC in rats and this effect was attributed to more pronounced anti-bacterial and anti-inflammatory effects of L. reuteri in its biofilm form, mainly due to more production of reuterin and histamine.92 It is known that L. reuteri produces more abundant quantities of anti-bacterial and anti-inflammatory factors, especially reuterin, in its biofilm state, compared to its planktonic state.77
A novel probiotic therapeutic in a murine model of Clostridioides difficile colitis
Published in Gut Microbes, 2020
Rita D. Shelby, Grace E. Janzow, Lauren Mashburn-Warren, Jeffrey Galley, Natalie Tengberg, Jason Navarro, Miriam Conces, Michael T. Bailey, Steven D. Goodman, Gail E. Besner
Human-feces derived L. reuteri 23272 (American Type Culture Collection; ATCC, Manassas, VA) was grown overnight in de Man, Rogosa, and Sharpe (MRS) broth (Fisher Scientific, Pittsburgh, PA) at 37°C in 5% CO2. For planktonic L. reuteri, 1 × 109 CFU/mL was pelleted and resuspended in sterile 0.9% saline prior to gastric gavage. For L. reuteri administered with unloaded microspheres, sterile dry dextranomer microspheres (Sephadex G-25 Superfine, GE Healthcare Bio-Sciences, Pittsburgh, PA) were hydrated in a sterile saline solution overnight. For L. reuteri administered with maltose-loaded microspheres, the microspheres were hydrated in a 1 M maltose solution in normal saline overnight. All microspheres were removed from the overnight solution via vacuum filter and aseptically transferred into a tube containing the resuspended bacteria. The bacteria were allowed to incubate with the microspheres for 1 hour at room temperature to facilitate binding. Each mouse received 200 μL of the bacterial solution by gastric gavage, for a final dose of 1 × 108 CFU of Lr.
Transient pseudohypo-aldosteronism
Published in Paediatrics and International Child Health, 2019
Neslihan Günay, Zeynep Küçükaydın, Seda Pınarbaşı, İsmail Dursun, Ruhan Düşünsel
A 53-day-old boy was admitted with fever and vomiting for 2 days. He had gained only 500 g a month since birth. Urinalysis confirmed a UTI. Serum sodium was 114 mmol/L (135–144), potassium 6.1 mmol/L (3.6–4.8), chloride 90 mmol/L (98–106), glucose 5.2 mmol/L (3.3–5.5), blood urea nitrogen 15.7 mmol/L (2.1–16.1), creatinine 66.3 μmol/L (15.0–37.1), bicarbonate 13 mmol/L (19–24) and urine sodium 26 mmol/L. Laboratory findings were compatible with hypo-aldosteronism and acute kidney injury. He was prescribed ampicillin and gentamicin, intravenous fluids and sodium bicarbonate. Klebsiella pneumonia (>106 colony-forming units/mL) was confirmed from the urine culture. Serum aldosterone and renin levels were 1253.2 ng/dL (3.7–43.2) and 179.4 pmol/L (<0.85), respectively. Ultrasound demonstrated bilateral grade 2 pelvicaliceal ectasia and ureteral dilation. Voiding cysto-ureterography showed bilateral grade 5 vesicoureteral reflux (VUR). It was treated by endoscopic correction with a subureteric injection of deflux, which is a viscous gel consisting of dextranomer microspheres and stabilised non-animal hyaluronic acid. Following these treatment strategies, his clinical condition and laboratory abnormalities returned to normal.