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Biomedical subjects

David B Joseph

Publications and source records attributed to David B Joseph.

5 recordsLinked to original sources
PubMed2006

Urinary incontinence.

Urinary incontinence is a common primary care problem. With the proper understanding of normal and abnormal bladder function, pediatricians can create a protocol that will benefit most children seen with this condition. Emphasis should be placed on primary therapy: establishing healthy dietary habits, treating constipation, maintaining appropriate hygiene, and developing a regular voiding pattern. When the initial evaluation identifies an anatomic abnormality or when primary therapy fails, referral to a pediatric urologist is warranted.

Child↗
PubMed2004

Splenogonadal fusion diagnosed by Doppler ultrasonography.

Splenogonadal fusion usually presents as a left scrotal mass but rarely is the diagnosis suspected preoperatively. Herein, we present the first report of a left splenogonadal fusion which was suspected preoperatively by doppler ultrasonography in a 2 year old boy.

Abnormalities, Multiple↗
PubMed2003

Testicular torsion: is there a seasonal predilection for occurrence?

OBJECTIVES: To test the hypothesis that there is a bimodal spring-fall seasonal predilection for acute testicular torsion and to compare our series with those previously reported outside the United States that support a seasonal predilection. METHODS: A retrospective chart review of operative notes was performed for all cases of acute torsion of the testis confirmed at surgery during a 15-year period at our institution. The diagnosis, child's age, and date of occurrence were verified; 135 confirmed cases were identified. RESULTS: The months with the highest incidences of acute testicular torsion were December (14%) and January (11%). Thirty percent of cases occurred in the fall (October, November, December), 24% in the winter (January, February, March), 22% in the summer (July, August, September), and 23% in the spring (April, May, June). CONCLUSIONS: No statistically significant differences were seen with regard to seasonal or monthly occurrence of acute torsion. However, the "cold" weather trend identified is consistent with those of larger international studies. It is possible that our regional monthly temperatures do not vary enough to demonstrate whether cold weather influences the incidence of torsion. To our knowledge, this is the only reported series regarding a seasonal predilection for torsion in the United States. A multi-institutional, prospective study representing all regions within the United States is needed to establish the significance of season and climate on testicular torsion.

Alabama↗
PubMed2003

Bladder neck cinch for pediatric neurogenic outlet deficiency.

PURPOSE: The fascial bladder neck sling achieves continence in 50% to 90% of children with neurogenic outlet deficiency. Most slings apply only partial pressure around the bladder neck. We evaluated the effectiveness of a rectus fascia bladder neck cinch which applies circumferential pressure around the bladder neck and elevation as a means of increasing outlet resistance. MATERIALS AND METHODS: Fifteen children with spina bifida underwent a fascial bladder neck cinch procedure at the time of augmentation cystoplasty. A 1 to 1.5 cm width of variable length rectus fascia was harvested and a vertical slit was made in 1 end. The fascia was "cinched" tightly around the bladder neck and secured to the symphysis or rectus fascia. RESULTS: The 14 girls and 1 boy ranged in age range from 4 to 17 years. All children had neurogenic intrinsic sphincter deficiency and a poorly compliant and/or small capacity bladder. Followup ranged from 10 to 36 months (followup in 12 greater than 1 year). Postoperatively, all children perform clean intermittent catheterization. At the last followup 8 girls and the boy (60%) were dry (no leak and no pads at 4 hours from the last catheterization and dry throughout the night). CONCLUSIONS: Rectus fascia used as a bladder neck cinch is effective but no better than other bladder neck slings for decreasing urinary incontinence. The bladder neck cinch appears to be an acceptable addition to the technique of fascial slings. However, we have subsequently changed our technique because these results did not meet our expectations.

Adolescent↗