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Biomedical subjects

M Darbey

Publications and source records attributed to M Darbey.

3 recordsLinked to original sources

Neurophysiologic assessment of urinary dysfunction in children with thoracic syringomyelia.

Isolated syringomyelia of the thoracic portion of the spinal cord is relatively uncommon. In children, signs and symptoms may involve only the urinary system. Five children who presented for evaluation of urinary tract dysfunction were found to have syringomyelia of the thoracic cord not associated with any other central nervous system abnormality on radiographic imaging. Each child underwent a complete neurologic examination and a complete electrophysiologic/urodynamic evaluation. One patient underwent surgical drainage of the syrinx due to progression of neurologic deficit, with slight improvement; three patients were treated pharmacologically to control the urinary dysfunction.

Child

[Environment, patient information, and organization in a pediatrics urodynamics unit].

OBJECTIVES: Urodynamic studies require patient cooperation, and this can be difficult in the pediatric age due to their invasive nature. Our aim was to assess the benefits of organization, facility design and information specifically adapted to children. METHODS: We describe the facility design and organization of the Urodynamics Unit at the Children's Hospital in Boston. Environmental factors are adapted to the pediatric age and aim to reduce the impact of the examination. There are child's objects, images and toys in the examining room. Parents are allowed to be in the room while the test is performed, and music is played during the procedure. We describe the information pattern and the behavior of the nurses and physicians to preserve the child's privacy. An information leaflet and a survey on symptoms is sent to parents before the test. Information is adapted to every age and aims to reduce parental anxiety towards the test and make them understand the need for the study. There are two premises for information: 1) every procedure will be explained to the child and parents, and 2) they will be told the truth. RESULTS: An enhanced cooperation has been noted following these guidelines. Between 5 and 8% of the studies performed are not evaluable due to lack of cooperation from the patient and only two children have totally refused the test in the last two years (0.2%). CONCLUSIONS: Cooperation among urologists and specialized nurses as well as attention towards the child's and parents' psychological factors can enhance the diagnostic yield of this test.

Adolescent