[The treatment of enuresis].
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Secondary nocturnal enuresis is generally seen between 5 and 7 years of age and it is rarely encountered when compared with the primary incontinence. Patients with suggested diagnosis of secondary nocturnal enuresis should be examined for neurological and spinal anomalies and diabetes mellitus, diabetes insipidus, renal failure and urinary tract infection should be ruled out in differential diagnosis (1-3). Herein, we are presenting case reports of adolescent patients with secondary nocturnal enuresis refractory to medical therapy and developed after in-vehicle and extravehicular accidents.
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Introduction Primary nocturnal enuresis is the most frequent urinary system complaint among pediatric patients. Material and Methods Data compiled from 5,500 children, aged between five to 16 years, diagnosed with enuresis during the period from January 2010 to December 2015 were analyzed. The inclusion criteria were having a diagnosis of monosymptomatic nocturnal enuresis, a birth date known for certain, and complete family history taken. A total of 3,547 children met the inclusion criteria and were included in the study. The study was performed by retrospective analyses. Results Analysis of the results revealed a statistically significant difference among the rates of enuresis with respect to months and seasons (p < 0.001). In our study, we retrospectively reevaluated 3,500 patients for their birth dates and determined a statistically significant difference in the rates of nocturnal enuresis with respect to seasons (p < 0.001). Conclusion As a result of this study, we determined that monosymptomatic nocturnal enuresis in children is more frequent, particularly in those born during the summer months.
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Introduction: Urinary incontinence during sleeping is a common condition in children older than four years. This is called nocturnal enuresis. In this study, we aimed to evaluate the sociodemographic characteristics of children with nocturnal enuresis and its relationships with etiology, diagnosis, treatment, and obesity. Materials and Methods: 692 patients diagnosed with primary nocturnal enuresis were screened retrospectively and included in the study. Their families were interviewed and asked to fill out the questionnaire form. This questionnaire form contained questions about gender, family history of nocturnal enuresis, frequency of nocturnal enuresis, presence of encopresis or constipation, monthly income, number of siblings, age at initiation of toilet training, sleep assessment, history of previous treatment, and perspective of families on their children’s medication use, height, and weight. The relationship of these variables with nocturnal enuresis was evaluated. Findings: Of the 692 patients included in the study, 262 (37.8%) were female and 430 (62.2%) were male. The mean age was 9.2 (5-16) years. 112 (16.1%) patients had a family history of nocturnal enuresis. 241 (34.9%) patients wet the bed every day, 341 (49.3%) patients wet the bed two or three days per week, 62 (8.9%) patients wet the bed one day per week or less, and 48 (6.9%) wet the bed one day per month or less. While 96 (13.8%) patients had accompanying chronic constipation, 13 (1.8%) patients had accompanying encopresis. The families of 386 (55.8%) patients had a monthly income of less than 1000 TL, the families of 214 (30.9%) patients had a monthly income between 1000-2000 TL, and the families of 92 (13.3%) patients had a monthly income of 2000 TL or over. When the number of siblings in the family was examined, 52 (7.6%) patients had no siblings, 394 (56.9%) patients had 4 or more siblings. When age at initiation of toilet training was examined, 534 (73.9%) patients received toilet training between the ages of 2 and 5 years. According to sleep assessment, 360 (52.1%) patients slept deeply. 338 (48.8%) patients received previous treatment. While the families of 358 (51.7%) patients took a positive approach to medication initiation, the families of 334 (48.3%) patients were hesitant to medication initiation due to medication side effects. According to body mass index (BMI) category, 262 (37.9%) patients were lean, 364 (52.7%) patients were normal weight, 42 (6%) patients were overweight, and 24 (3.4%) patients were obese. Conclusion: Nocturnal enuresis is an important health problem that adversely affects children. In order to solve this problem, it is necessary to raise family awareness about nocturnal enuresis, to assess the socioeconomic status of the family, to determine whether there is a genetic predisposition in the family, and to reveal the presence of additional diseases in the child. The family should be adequately informed about the treatment. It should be explained to the family that nocturnal enuresis should be followed up. We think that there is a need for further studies on this subject.
Encopresis
Etiology
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Enuresis may be caused by organic diseases and by malformations. The present discussion, however, has to do only with the incontinence of urine ordinarily seen in childhood. In order to understand the treatment of this condition, it is necessary to know so far as possible the physiology of normal urination. This was described by Goltz1in 1874, and the general principles set forth by him at that time have continued to be accepted with little modification. Stated in its simplest terms, the act of micturition may be described as follows:2Gradual distention of the bladder induces rhythmic contraction of its walls. This contraction increases until a few drops of urine are expressed into the posterior urethra, causing a sensory stimulus, the afferent part of the reflex, which, passing to its nerve center in the lumbosacral cord, arouses the afferent impulses by which the bladder is made to contract
Urination
Stimulus (psychology)
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The aim of this study was to determine the frequency and characteristics of secondary enuresis in children initiated on valproate treatment.This was a prospective study conducted in children aged 5 to 12 years with suspected newly diagnosed epilepsy and maintained on valproate for at least 1 month. Adverse events spontaneously reported by parents were recorded at each follow-up visit. In addition, we specifically asked about enuresis and other side effects known to occur with valproate treatment. We assessed the frequency of enuresis and its association with a number of variables.Seventy-two children (43 males and 29 females) with a mean age of 8 years 7 months (range 5-12y) were included in this study. Secondary enuresis developed in 17 (24%) of these children after, on average, 19.8 days of exposure to valproate. The data obtained from a multivariate analysis indicate that age was the only significant factor in predicting the development of enuresis. Enuresis ceased in all children after discontinuation of valproate use, and in 10 out of 11 children still on the drug.Secondary enuresis is a common adverse event associated with valproate use in children, which is not usually spontaneously reported and is reversible in most cases.
Discontinuation
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Congenital hypothyroidism
Primary (astronomy)
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Congenital Neutropenia
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Objective:To analyze the clinical characteristics of Kawasaki disease in the infants less than 6 months old which lead to early observation and diagnosis of KD in infants and decrease the incidence of coronary complications.Methods:Retrospective analysis of clinic data of 26 KD infants less than 6 months old from January 2005 to May 2010 in our hospital were done.Results:The clinic characteristics of KD in infants less than 6 months old were atypical,most of them presented incompletely and the coronary artery always were injured.Long time was spent to diagnose and many were misdiagnosed.Conclusion:It is the only way for early diagnosis KD in infants that coronary artery was monitored in suspicious patients.Infants less than 6 months old should be suspicious of KD who had fever lasting for at least 5 days with unknown reasons and the treatment is not efficient.It could lead to early diagnosis and improve prognosis.
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