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Respiratory, endocrine, cardiac, and renal topics
Published in Evelyne Jacqz-Aigrain, Imti Choonara, Paediatric Clinical Pharmacology, 2021
Evelyne Jacqz-Aigrain, Imti Choonara
Bedwetting is a common, but socially disruptive and stressful condition, in school age children; with a prevalence rate of 15–20% at age 5, 8–10% at age 6, 3–4% at age 10 and 1–2% in young adults, without any significant difference between countries and cultures [1–5]. Two thirds experience monosymptomatic nocturnal enuresis (mainly boys) and one third suffer from voiding disorder (mainly girls), sometimes leading to persistent troubles toward adulthood. This chapter will focus on monosymptomatic nocturnal enuresis.
Neurofeedback in Application to the ADHD Spectrum
Published in Hanno W. Kirk, Restoring the Brain, 2020
Nicky, an 8-year-old boy, had been diagnosed three years prior to coming to see us for ADHD symptoms. His mother described him as a very smart child who was highly impulsive and hyperactive, had poor self-control, and a short attention span. He had difficulties organizing, was distractible and forgetful, and was impatient and easily frustrated. He was always rushing through tasks which led to him making mistakes and had some difficulties with math and spelling. He always wanted to do as little as possible to get by and had poor self-confidence. He was playing the class clown in order to feel accepted and would manipulate anyone to get his way by lying and cheating, about which he never exhibited remorse. He was fearless, selfish and careless, and never personally at fault. Most recently he had gotten in trouble in school for aggressive behaviors. He was also biting his nails, mostly when under pressure. He had stomach aches with constipation, and sugar cravings were an issue as well. Bedwetting had been a problem in the past but had stopped a few months back.
What Actually Is Sleep?
Published in Zippi Dolev, Mordechai Zalesch, Judy Kupferman, Sleep and Women's Health, 2019
Zippi Dolev, Mordechai Zalesch, Judy Kupferman
In fact, this is the combination of two different stages previously called stage 3 and stage 4. Characteristics: Additional decrease in the frequency of the brain waves, in body heat, in breathing rhythm and in blood pressure; there are no eye movements whatsoever. In this stage, bedwetting can appear in children. Others may experience sleepwalking or nightmares that cause wakefulness and fright.Sleep quality: Characterized by a difficulty in waking up. Those who wake up at this stage will feel confused for several minutes.Role: This stage appears mostly in the first cycles of sleep. It is in this stage that the largest amount of growth hormone is released; hence its importance for children and adolescents. This stage is extremely important for brain energy renewal and the balancing of many body systems: temperature regulation, immune system function, blood pressure equilibrium, sugar levels, and insulin-release balance. Undoubtedly, this is one of the most important sleep stages.
Evaluation of boys with daytime incontinence by combined cystourethroscopy, voiding cystourethrography and urodynamics
Published in Scandinavian Journal of Urology, 2021
Lilia Winck-Flyvholm, Karen Damgaard Pedersen, Simone Hildorf, Jorgen Thorup
Between 2010 and 2018, we investigated 75 boys aged 5–14 (median age 9) years old according to a prospective set-up with cystourethroscopy including application of a suprapubic catheter in general anesthesia and within 24 h thereafter VCUG followed by urodynamic combined cystometry and pressure-flow study. All boys had daily problems with urinary incontinence, urgency and eventually frequency (more than seven times per day). The median number of daily voiding was 7 and 57% (43/75) of the boys had frequency. Nocturnal enuresis, defined as bedwetting at least once a month, was also noted in 46 boys. Prior to inclusion all boys had previously tried urotherapy for a period of 3 months to 5 years (median 1 year) and the minority (23%, 17/75) had additionally included periods of anticholinergic treatment with unsatisfactorily effect. The urotherapy regime included evaluation and regular monitoring with three days frequency volume charts, uroflowmetry and bladder emptying by ultrasonography. None of the boys had any previous episodes of urinary tract infection (UTI) recorded. None of the boys had neurological symptoms or abnormalities and none had obstructive flow pattern at repeated uroflowmetry. All the boys had normal upper urinary tract estimated by ultrasound examination. The boys had follow-up for 1 month to 9 years (median 2 years and 8 months).
Update on nonpharmacological interventions in parasomnias
Published in Postgraduate Medicine, 2020
Maria Ntafouli, Andrea Galbiati, Mary Gazea, Claudio L.A. Bassetti, Panagiotis Bargiotas
Early studies assessed the efficacy of pharmacotherapies (i.e. imipramine) [36], however, in the recent years an increasing number of studies and case reports reported efficacious behavioral strategies, often in combinations, to manage sleep enuresis. Several studies and case reports highlighted the efficacy of behavioral treatments against bedwetting in children and young people. Simple and complex interventions have been reported. Simple interventions included rewarding for dry nights, ‘lifting’ (the caregiver lift the subject/child from their bed while they sleep and walking the child to the bathroom to pass urine, without necessarily waking the child) and bladder training (which is based on retention control training and fluid restriction). Even, the use of a diary, in which the patients note dry and wet nights has shown to be useful in reducing frequency of SE in 15%–20% of children with SE [35].
Efficacy and safety of intradetrusor onabotulinumtoxinA injection for managing paediatric non-neurogenic overactive bladder: A prospective case-series study
Published in Arab Journal of Urology, 2019
Amr S. El-Dakhakhny, Tarek M. El-Karamany, Mohamed El-Atrebi, Tarek Gharib
The protocol of this prospective clinical trial was approved by the Local Ethics Committee and parents of enrolled patients signed a written fully-informed consent to participate in the study and receive the assigned lines of management. All children and adolescents aged 5–16 years, with a past history of dryness and recurrence of bed wetting or day wetting later on, and did not improve after 6 months of strict bladder retraining, were eligible for evaluation. Only patients having OAB as diagnosed by UDS were included in the study. Exclusion criteria included: the presence of UTIs both current infections, evidenced by urine analysis and culture, or within the last 2 months; presence of abnormalities of urinary tract or nervous system, and any known genetic or craniofacial syndromes; systemic diseases such as diabetes mellitus, cystic fibrosis; and obstructive sleep apnoea.