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Biomedical subjects

Joseph G Barone

Publications and source records attributed to Joseph G Barone.

16 recordsLinked to original sources
PubMed2006

The effect of surgeon volume and hospital characteristics on in-hospital outcome after ureteral reimplantation in children.

The aim of this study was to examine the association between surgeon and hospital characteristics on in-hospital outcome after ureteral reimplantation in children. Patients<18 years undergoing vesicoureteral reimplantation (n=3,109) were identified in Kids' Inpatient Database, an administrative database containing discharge records from 27 states during 2000 in the US. Based on patient volume in 2000, surgeons were designated as low volume (<11 procedures), medium volume (11-20 procedures) and high volume (>20 procedures) surgeons. Length of stay and hospital charges were analyzed using multivariate linear regression analysis. A significant association between shorter length of stay and higher surgeon volume (p=0.02) was observed that was independent of children's hospital status, hospital volume and other hospital characteristics. Length of stay was 20% shorter when the procedure was performed by the highest volume surgeons compared to when performed by the lowest. No significant effect of surgeon volume on hospital charges, however, was observed. Higher surgeon volume was associated with shorter length of stay but no difference in hospital charges among children undergoing vesicoureteral reimplantation.

Child↗
PubMed2006

Nonoperative management of abdominoscrotal hydroceles in an infant.

Early surgery is recommended for infant abdominoscrotal hydrocele because spontaneous resolution has not been reported. We present a 6-month-old boy with bilateral abdominoscrotal hydrocele, who did not undergo surgery because of a hematologic condition. After 1 year, the abdominal portion of both hydroceles resolved, leaving simple bilateral scrotal hydroceles.

Abdomen↗
PubMed2006

Pediatric renal pseudocyst due to pancreatitis.

A renal pseudocyst due to pancreatitis should be suspected when a child with pancreatitis develops flank pain. Percutaneous drainage of the pseudocyst provides effective treatment of this rare condition.

Abdominal Injuries↗
PubMed2006

Breastfeeding during infancy may protect against bed-wetting during childhood.

OBJECTIVE: Our goal was to test the hypothesis that children who exhibit bed-wetting during childhood were less likely to be breastfed during infancy compared with normal controls. METHODS: A case-control study was conducted in a pediatric continence center and a general pediatric practice. Cases (n = 55) were recruited from the continence center and defined as children 5 to 13 years of age who experienced lifetime involuntary voiding of urine during nighttime sleep at least 2 times a week in the absence of defects of the central nervous system or urinary tract. Age- and gender-matched controls (n = 117) who did not exhibit bed-wetting were enrolled from a general pediatric practice. Infant feeding practices were measured as breastfeeding (yes/no) and, for those who were breastfeed, by the duration of breastfeeding and the time of formula supplementation. RESULTS: Among the case subjects, 45.5% were breastfed, whereas among the controls 81.2% were breastfed. The controls reported higher household incomes than the case subjects, and their mean family size (number of children) was slightly lower. After adjusting for race, income, and family size, the odds ratio was 0.283, indicating that case subjects were significantly less likely than controls to be breastfeed. Among all the study subjects who were breastfed, controls were breastfed for a significantly longer period than case subjects (an average of 3 months longer). Although breastfed controls were less likely to be supplemented with formula than breastfed case subjects, this difference was not statistically significant. CONCLUSIONS: Breastfeeding longer than 3 months may protect against bed-wetting during childhood. Breast milk supplemented with formula did not make a difference in the rate of enuresis.

Breast Feeding↗
PubMed2005

Patterns of inheritance in familial prune belly syndrome.

We present a case of familial prune belly syndrome and review potential modes of inheritance for the syndrome. A total of 11 cases of familial prune belly syndrome have been reported. These cases were reviewed and possible modes of inheritance were determined for each case. Our review strongly suggests a sex-influenced autosomal recessive mode of inheritance.

Female↗
PubMed2005

Bladder rupture in premature infant during voiding cystourethrography.

We report what we believe to be the youngest patient with bladder rupture during voiding cystourethrography. If voiding cystourethrography needs to be done in a premature infant, the filling pressures should be minimized, multiple filling cycles should be avoided, and the voiding pressures should be minimized by using a small, balloon-less catheter.

Female↗
PubMed2003

Pediatric pyogenic granuloma of the glans penis.

Pyogenic granulomas are benign vascular proliferations of the skin and mucous membranes. We present a case report of a 13-year-old uncircumcised boy with phimosis and a pyogenic granuloma of the glans penis. The relationship between these lesions, phimosis, smegma, and circumcision is discussed. When the lesion is found in conjunction with phimosis, consideration should be given for circumcision. Close follow-up to rule out recurrence is necessary.

Adolescent↗
PubMed2003

The surgical treatment of labial adhesions in pre-pubertal girls.

STUDY OBJECTIVE: A review of our experience with the surgical treatment of labial adhesions refractory to medical treatment. DESIGN: Retrospective review. SETTING: University tertiary care hospital same-day surgery center. PARTICIPANTS: Nine prepubertal females, age 3-6 yrs, presenting with thick, symptomatic labial adhesions refractory to medical management. INTERVENTION: All patients underwent surgical lysis of labial adhesions under general anesthesia. Adhesions were incised sharply and the cut edges were reapproximated with 7-0 chromic suture by a pediatric urologist (JGB). MAIN OUTCOME MEASURES: Duration of recurrence-free follow-up. RESULTS: No patient had recurrence in an average of 8.6 months of follow-up. Surgery was well tolerated in all cases. CONCLUSION: This technique effectively treats and prevents the recurrence of moderate to severe labial adhesions that are unresponsive to medical therapy.

Administration, Topical↗
PubMed2003

Urinary ascites secondary to forniceal rupture in a child with the Prune Belly Syndrome.

Despite adequate bladder catheterization, a neonate with Prune Belly Syndrome developed urinary ascites secondary to forniceal rupture. Treatment consisted of bilateral cutaneous pyelostomies. Even though most children with Prune Belly Syndrome respond to lower urinary tract drainage, a cutaneous pyelostomy may be necessary when the ureters are tortuous and do not drain adequately following bladder decompression.

Ascites↗
PubMed2003

Anatomic variants associated with newborn circumcision complications.

OBJECTIVE: Circumcision is one of the commonly performed procedures on males in the United States, Canada, Australia, and the United Kingdom. The association of minor anatomic variations of the newborn genitalia in patients with minor circumcision complications has not been previously examined. In this study, we looked for an association between subtle genital anatomic variations and newborn circumcision complications. MATERIALS AND METHODS: Over an 18-month period, children presenting for circumcision revision were examined for minor variations in genital anatomy. Children referred for other urological problems during the same period comprised the control group. The same physician evaluated all of the children. RESULTS: During this period, 68 children were evaluated for possible circumcision complications. A confirmed complication was present in 57 infants. Patients with a minor circumcision complication were found to have a 9-fold higher incidence of a prominent suprapubic fat pad, penoscrotal webbing, or being a premature infant as compared to the control group. CONCLUSIONS: Subtle anatomic variations may be associated with a higher incidence of circumcision complications. Physicians performing newborn circumcisions should thoroughly examine the genitalia for these anatomic variations prior to the procedure in order to reduce potential complications.

Circumcision, Male↗
PubMed2002

Novel assay for determining DNA organization in human spermatozoa: implications for male factor infertility.

OBJECTIVES: To present a novel assay for determining DNA organization in fertile human spermatozoa and establish morphometric parameters for these samples. The three-dimensional organization of DNA within a cell nucleus is intimately related to cellular function. For example, it has recently been demonstrated that normal sperm DNA organization may be necessary for successful in vitro fertilization in the mouse. METHODS: Semen from 12 fertile volunteers was tested for sperm DNA organization using our nuclear matrix stability assay. Sperm DNA then underwent computerized digital image analysis and standards of normal were established. RESULTS: Sperm DNA organization was constant in all samples tested. Normal parameters established included mean nuclear matrix diameter (9.17 +/- 1.59 microm), mean DNA halo diameter (20.56 +/- 2.53 microm), mean halo area (66.88 +/- 7.92 microm(2)), and mean nuclear matrix area (32.98 +/- 4.3 microm(2)). CONCLUSIONS: This assay may be used to determine DNA organization in a semen sample. Defining sperm DNA organization may be important clinically, because normal DNA organization is necessary for normal cellular function.

Adult↗
PubMed2002

Childhood infundibular stenosis.

Infundibular stenosis is a rare condition marked by dilation of one or more calices proximal to a stenotic infundibulum. Contrary to older reports, more recent information suggests that progressive renal dysfunction occurs in a significant number of these patients. We present a case of incidentally discovered infundibular stenosis. On the basis of the existing published reports, we make several recommendations. Close monitoring for a decline in renal function secondary to hyperfiltration injury is essential, and a worsening should prompt referral to a pediatric nephrologist. Progressive hydronephrosis should be corrected surgically, although proof of effect on the disease process is lacking in the evidence-based reports.

Child, Preschool↗
PubMed2002

Urethral prolapse: four quadrant excisional technique.

BACKGROUND: Urethral prolapse is a condition that occurs when urethra mucosa evaginates beyond the urethra meatus, resulting in vascular congestion and edema of the prolapsed tissue. Young females with this clinical entity often present with peri-vaginal bleeding and swelling. Urethral prolapse can be diagnosed by its typical clinical appearance and should not be confused with other causes of peri-vaginal bleeding, most importantly, sexual abuse. CASE: We retrospectively evaluated the charts of three girls, ages 4, 6, and 8, who presented complaining of vaginal blood spotting. On examination, a ring of congested, edematous tissue was seen prolapsing through the urethral meatus in each patient. All patients did not respond to medical management and required surgical removal of the tissue. We herein discuss and evaluate their management and our four quadrant excisional technique. CONCLUSION: Urethral prolapse can be definitively diagnosed without laboratory or radiographic evaluation by demonstrating that the edematous tissue surrounds the meatus circumferentially. Initial treatment consists of parental reassurance, observation, and warm soaks. If the prolapse does not demonstrate improvement, excision of the prolapsing tissue may be necessary. We believe that our surgical technique facilitates removal of the prolapsed tissue and anastomosis of the residual urethral mucosa.

Child↗
PubMed2002

Management of urethral catheter knot in a neonate.

To accommodate the small size of the infant urethra, finer, more flexible tubes are often used for urinary catheterization in the pediatric intensive care units. These tubes have the ability to knot in the bladder, occasionally requiring surgical removal. The mechanism of knotting appears to result from excessive intravesical catheter coiling, and as the bladder decompresses the catheter tip can migrate through a coil thereby creating a knot. Review of the literature from 1975 to 2000 identified 19 cases of urethral catheter knotting in the pediatric bladder with two reports of prostatic urethral involvement. Herein, we describe the first reported instance of catheter knotting within the penile urethra and describe the surgical technique employed for its removal.

Catheters, Indwelling↗