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PubMed1986

Bladder stone disease in children in Afghanistan.

Of 132 children with bladder stones seen in 1 year, 94% were boys and 73% were aged between 1 and 5 years. Significant malnutrition and evidence of vitamin deficiency were absent. Wheat bread was the dietary staple, while the intake of milk and dairy products, eggs and meat was very low. Analysis of 29 stones showed them to consist mainly of calcium oxalate and uric acid, with small amounts of calcium phosphate and magnesium ammonium phosphate in some cases. The composition of the surface and central parts of the stones, examined in 20 cases, was usually different. The nucleus was formed almost entirely of calcium oxalate and uric acid in four and three cases respectively, whereas the surface layers were composed of other ingredients. In another case the nucleus was composed entirely of xanthine, which indicated a diagnosis of xanthinuria.

Afghanistan↗
PubMed1980

Positive bethanechol chloride supersensitivity test in hereditary sensory neuropathy.

An 11-year-old girl with hereditary sensory neuropathy (type II) presented with neurogenic bladder disease. Urodynamic evaluation revealed a sensory neurogenic bladder and a markedly positive bethanechol chloride supersensitivity test. This case report supports Lapides' original observation that a positive bethanechol chloride supersensitivity test may occur in pure sensory neurogenic bladder disease.

Bethanechol Compounds↗
PubMed2001

Galectins and other endogenous carbohydrate-binding proteins of animal bladder.

Defects in the glycocalyx of the bladder epithelium may be related to the development of bladder diseases including interstitial cystitis which is a chronic bladder disease of unknown etiology. Indirect evidence has implicated alterations in the bladder epithelial glycoconjugates in interstitial cystitis and vesicaler instillation of glycosaminoglycans is promoted as treatments. However, information on the nature of the glycoconjugates of the bladder epithelium and lectins that may interact with the exogenous instilled glycoconjugates is very limited. We have examined the endogenous lectin associated with bladder epithelium by immunohistochemistry using biotinylated neoglycoconjugates. The strong calcium-independent binding of beta-D-galactose probe suggested the presence of galectins in rabbit and human bladder. Extracts of rabbit bladder organ cultures metabolically labeled with [14C]-amino acids were subjected to affinity chromatography on immobilized lactose and the specifically bound material eluted with 0.2 M lactose. SDS-PAGE of the recovered proteins revealed a major band of approximately 30 kDa and a minor band of 21 kDa. Polymerase chain reaction and northern blot analysis showed that both galectin-3 and galectin-4 are expressed in rabbit bladder. Since galectin-3 from rabbit had been previously cloned, we cloned and sequenced galectin-4 from rabbit bladder. The deduced full length sequence of 328 amino acids revealed four distinct regions: a N-terminal peptide of 19 residues, two carbohydrate recognition domains of 130 residues each, and a linker region of 49 residues. Comparison of the rabbit galectin-4 sequence with those of human, pig, rat, and mouse revealed two invariant peptide motifs that are proposed as signature sequences for identifying related galectins.

Animals↗
PubMed1998

Further delineation of the Opitz G/BBB syndrome: report of an infant with complex congenital heart disease and bladder exstrophy, and review of the literature.

The combination of complex congenital heart disease (double outlet right ventricle with pulmonary atresia, malalignment ventriculoseptal defect, right-sided aortic arch with left ductus arteriosus) and bladder exstrophy occurred in an infant with Opitz syndrome. Neither of these defects has previously been reported in association with Opitz syndrome. These malformations, which are midline defects, further characterize this syndrome as an impairment in midline development. The spectrum of congenital heart disease and genitourinary anomalies seen in Opitz syndrome is reviewed.

Abnormalities, Multiple↗
PubMed1980

Cecocystoplasty in the surgical management of the small contracted bladder.

Preliminary results have been reviewed for 17 patients with a small contracted bladder from chronic inflammatory disease who underwent cecocystoplasties. Except for 1 patient who was lost to followup results were considered excellent in 11, good in 2 and a failure in 3. The amount of diseased bladder resected and the configuration of the cecal segment used did not seem to bear any relationship to the surgical outcome. The importance of a concurrent Y-V plasty is emphasized. No case of significant electrolyte imbalance has been encountered. Results can be gratifying in selected patients after detailed voiding pattern documentation and thorough urological study ahve been completed.

Adolescent↗
PubMed1997

Concentrations of specific epithelial growth factors in the urine of interstitial cystitis patients and controls.

PURPOSE: Interstitial cystitis (IC) is a chronic bladder disease for which the etiology is unknown. Because the bladder epithelium is often abnormal in IC, we determined whether the levels of specific urine growth factors postulated to be important for bladder epithelial proliferation are altered in IC. MATERIALS AND METHODS: ELISAs were used to determine levels of epidermal growth factor (EGF), insulin-like growth factor 1 (IGF1), insulin-like growth factor binding protein 3 (IGFBP3), and heparin binding epidermal growth factor-like growth factor (HB-EGF) in urine specimens from women with IC, asymptomatic women without bladder disease, and women with bacterial cystitis. RESULTS: Urine HB-EGF levels were specifically and significantly decreased in IC patients as compared to asymptomatic controls or patients with bacterial cystitis, whether expressed as concentration (amount per volume of urine) or the amount relative to urine creatinine in each specimen. In contrast, urine EGF, IGF1, and IGFBP3 levels were all significantly elevated in IC patients compared to asymptomatic controls. Further, the amounts of urine EGF and IGF1 were also elevated in IC patients as compared to patients with bacterial cystitis, and urine IGFBP3 levels were significantly elevated when expressed per milligram of urine creatinine. CONCLUSIONS: These findings indicate that complex changes in the levels of urine epithelial cell growth factors (EGF, IGF1, and HB-EGF) and a growth factor binding protein (IGFBP3) are associated with IC. While EGF, IGF1, and IGFBP3 levels are either the same or increased in the urine of IC patients as compared to patients with bacterial cystitis or asymptomatic controls, HB-EGF levels are significantly decreased in the urine of IC patients. Understanding the reasons for these changes may lead to understanding the pathogenesis of this disorder.

Adult↗
PubMed1978

Hepatobiliary imaging: a comparison of 99Tcm-dihydrothioctic acid and 99Tcm-pyridoxylidene glutamate in the non-jaundiced patient.

A comparison of two hepatobiliary imaging agents, 99Tcm-dihydrothioctic acid (99Tcm-DHT) and (99Tcm-pyridoxylidene glutamate (99Tcm-PG) has been carried out in 44 non-jaundiced patients. Thirty-one patients were admitted for investigation of upper abdominal pain and 13 patients were volunteers who were undergoing treatment for unrelated conditions. Satisfactory liver images were obtained with both agents in patients without liver disease, but they were inferior to those seen after 99Tcm-sulphur colloid. 99Tcm-PG produced clearer images of the gall-bladder and bile ducts than 99Tcm-DHT. Non-visualization of the gall-bladder was interpreted as gall-bladder disease; in patients with inflammatory gall-bladder disease no gall-bladder image was seen (nine 99Tcm-DHT, nine 99Tcm-PG). The gall-bladder was also not demonstrated in two of the volunteers' group (one 99Tcm-DHT, one 99Tcm-PG), nor was a gall-bladder seen in five patients whose abdominal pain was not due to acute cholecystitis. Despite this, there was agreement between the results of imaging and oral cholecystography in 21 out of 22 subjects. 99Tcm-PG is non-toxic, cheap and rapidly excreted by the liver into the bile. A 99Tcm-PG scan would be useful when rapid diagnosis is required in suspected acute cholecystitis when conventional contrast radiology is unlikely to be of value.

Adult↗
PubMed2004

Defining overactive bladder: epidemiology and burden of disease.

Overactive bladder (OAB) is a common, disabling condition associated with considerable negative impact on quality of life, quality of sleep, and mental health. The age-specific prevalence of OAB is similar among men and women. Urge incontinence affects only a portion of the OAB population: 33% of patients have OAB with urge incontinence ("OAB wet"), while 66% have OAB without urge incontinence ("OAB dry"). The symptoms of OAB can affect social, psychological, occupational, domestic, physical, and sexual aspects of life. OAB can also lead to depression and low self-esteem. The shift away from urodynamic observation (essential in the identification of OAB) reflects increased emphasis on the symptom-specific nature of this common disorder. The overall costs of OAB to society are in the billions. Yet the condition often goes unrecognized, largely because of the reluctance of those with OAB to seek medical attention.

Cost of Illness↗
PubMed1989

Obesity: basic considerations and clinical approaches.

Obesity, defined as an excess of body fat, can be measured with a variety of techniques, but in most epidemiologic studies it is estimated from height and weight or from skinfold thickness. The "gold standard" for body fat is the body density from which fat and fat-free body mass can be calculated. The new technique of bioelectric impedance analysis may substantially improve the estimation of total body fat. For estimating regional fat distribution, either waist to hip circumference ratio or subscapular skinfold have been most useful. Using the body mass index, defined as weight in kilograms divided by the square of the height in meters (kilogram per square meter), the National Health and Nutrition Examination Survey estimated that 26%, or 34 million, adult Americans aged 20 to 75 were overweight. The prevalence of severe overweight (a body mass index above 30 kg/m2) is higher in the United States and Canada than in Great Britain, the Netherlands, or Australia. Obesity results from an increase in energy intake relative to expenditure. Total daily energy expenditure includes energy used during resting metabolism, energy associated with the ingestion of food, and energy needed for physical activity. The obese are often observed to be less active, but since carrying a heavier load requires more energy, their total energy expenditure may not be low. A low resting metabolic rate has been suggested as a predictor of future risk of becoming obese. Adipose tissue is the major site for fat storage and may contain more than 90% of total energy stores. The increase in body mass index or degree of body weight is associated with an increased risk of heart disease, hypertension, gall bladder disease, and diabetes mellitus. When fat is centrally located in either males or females, the risk for these diseases is also increased, and may be a more important risk factor than total overweight itself. Genetic factors form the background from which obesity develops. The best estimates suggest that these genetic factors may be of less importance than environmental events in determination of total body fat and its distribution. Obesity can be classified on the basis of the total number of fat cells and regional fat distribution by using the etiological factors which caused the obesity or by determining the age at which the obesity began. Regardless of the cause, treatment for obesity should be based on an evaluation of the individual's risk from obesity as compared with the risk of the treatment under consideration. (ABSTRACT TRUNCATED AT 400 WORDS)

Female↗
PubMed1981

Fate of vesicoureteral reflux in children with neuropathic bladders managed by intermittent catheterization.

During the last 9 years 49 children with vesicoureteral reflux and neurogenic bladder dysfunction were treated with intermittent catheterization. Reflux spontaneously abated in 22 of 72 ureters (31 per cent). Reflux has been followed non-operatively in 17 ureters without renal deterioration. Reimplantation was successful in 24 ureters. In no instance was there ureterovesical obstruction or recurrence of the reflux and in none of the 12 unilateral reimplantations did contralateral reflux develop. Our experience suggests that children with reflux may be managed safely by intermittent catheterization, and that ureteroneocystostomy is reliable and effective in neurogenic bladder disease provided that bladder dysfunction is controlled.

Adolescent↗
PubMed2001

Prevalence of coronary risk factors in healthy adult Kuwaitis.

Obesity has been shown to be a serious health risk and is associated with a wide range of comorbid conditions, including diabetes mellitus, coronary heart disease (CHD), gall bladder disease, hypertension, osteoarthritis, and certain cancers. Studies in Kuwait and other Gulf States indicate that obesity is prevalent and may be increasing. Previous studies in Kuwait have mostly focused on the epidemiology of overweight and obesity in children, adolescents, and young adults. Relatively less is known about the prevalence of overweight and obesity and its correlates in older adults for whom obesity may be more closely related to CHD risk. The purpose of this study was to examine the prevalence of overweight and obesity in 9755 adult men and women and to determine the relationship of weight to other risk factors for chronic disease. For the first time we examine a sample of older Kuwaitis to explore the relationship between high BMI, hypercholesterolemia and hyperglycemia. One-third of adult Kuwaitis are obese (BMI > 30 kg/m2), 4.7% of Kuwaiti females have severe obesity (BMI > 40 kg/m2). BMI, cholesterol, and glucose values increase with age across the life span. Older Kuwaitis have a greater constellation of risk factors for chronic diseases. The results of a multiple linear regression model in which cholesterol values were studied, controlling for age, BMI, blood glucose, and sex revealed that age, BMI and sex were significant predictors of cholesterol values. These results indicate that actions to reduce obesity, hypercholesterolemia, and hyperglycemia are needed.

Adult↗